Lucke C, Phillip J, Krause D
Geriatrisches Zentrum Hagenhof, Langenhagen.
Unfallchirurg. 1995 May;98(5):272-7.
During the last 15 years new methods for the surgical treatment of pertrochanteric fractures have been developed [e.g. the dynamic hip screw (DHS) and the gamma-nail (GN)]. We report on the results obtained in 450 patients operated on between 1979 and 1984 (period I), from 1986 to 1989 (period II), and between 1991 and 1993 (period III); we reviewed the results with the intension of finding whether application of the new methods led to better results, shorter stay in hospital and fewer complications. The mean age of all patients was 79 years and was 4 years higher in period I to than in period III (77.5 +/- 9.2 vs 81.5 +/- 8.4). During period I, 65% of the fractures were stabilized using Ender rods, while during period III the DHS was used in nearly 60% and the GN, in 22%. The total hospital stay (department of surgery and geriatric hospital) decreased from 80.4 +/- 31.7 in period I to 66.6 +/- 24 days in period III (P < 0.001). Serious complications decreased by 80% during this time. During period I 86.2% of patients could be discharged home, as against 89.0% in period II and 94.7% during period III. The introduction of new operative techniques for the treatment of pertrochanteric fractures in the elderly was followed by a dramatic shortening of hospital stay, a reduced incidence of complications, early weight-bearing and an increased rate of discharge home.
在过去15年中，已开发出治疗转子间骨折的新手术方法[例如动力髋螺钉（DHS）和伽马钉（GN）]。我们报告了1979年至1984年（第一阶段）、1986年至1989年（第二阶段）以及1991年至1993年（第三阶段）期间450例接受手术治疗患者的结果；我们回顾这些结果，旨在确定新方法的应用是否能带来更好的效果、缩短住院时间并减少并发症。所有患者的平均年龄为79岁，第一阶段比第三阶段高4岁（77.5±9.2对81.5±8.4）。在第一阶段，65%的骨折采用Ender钉固定，而在第三阶段，近60%使用DHS，22%使用GN。总住院时间（外科和老年医院）从第一阶段的80.4±31.7天降至第三阶段的66.6±24天（P<0.001）。在此期间，严重并发症减少了80%。第一阶段86.2%的患者可出院回家，第二阶段为89.0%，第三阶段为94.7%。老年转子间骨折治疗新手术技术的引入，使住院时间大幅缩短、并发症发生率降低、可早期负重并提高了出院回家的比例。
