Clinical effect of closed reduction combined with external fixaton in the treatment of intertrochanteric fracture of femur in high risk elderly
TIAN Yafeng1 LIU Shizhao2 YAO Xingbao1 YU Jian1 REN Weiliang3 LI Yanli4 WANG Jinbang3 QI Liqing3
1.First Department of Orthopaedic, Hebei Provincial Hospital of Chinese Medicine, Hebei Province, Shijiazhuang 050011, China;
2.Emergency Department, Hebei Provincial Hospital of Chinese Medicine, Hebei Province, Shijiazhuang 050011, China;
3. Third Department of Orthopaedic, Hebei Provincial Hospital of Chinese Medicine, Hebei Province, Shijiazhuang 050011, China;
4.Operation Room, Hebei Provincial Hospital of Chinese Medicine, Hebei Province, Shijiazhuang 050011, China
Abstract:Objective To explore the clinical effect of the closed reduction combined with external fixaton in the treatment of intertrochanteric fracture of femur in high risk elderly. Methods From May 2012 to May 2016, 92 patients with femoral intertrochanteric fracture over 60 years old treated in Hebei Provincial Hospital of Traditional Chinese Medicine were divided into the treatment group and the control group by random number table, with 46 cases in each group. The treatment group was given closed reduction combined with external fixaton and the control group was given skeletal traction, both of them were followed up for 6 months after operation. The Harris score and the incidence of complications were compared between the two groups. Results The Harris score in the treatment group was higher than that of control group, the incidence of complications in the treatment group was lower than that of control group, with statistically significant differences (P < 0.05). Conclusion The clinical effect of the closed reduction combined with external fixaton in the treatment of intertrochanteric fracture of femur in high risk elderly is good. It can reduce the incidence of complications. The advantages are appropriate for elderly patients who are poor tolerance for surgery and with more internal medical diseases. It is worthy of clinical promotion and application.
田雅峰1 刘士昭2 姚兴豹1 于健1 任伟亮3 李彦丽4 王金榜3 齐立卿3. 闭合复位组合式外固定架治疗高危老年股骨粗隆间骨折的临床效果[J]. 中国医药导报, 2018, 15(6): 63-66.
TIAN Yafeng1 LIU Shizhao2 YAO Xingbao1 YU Jian1 REN Weiliang3 LI Yanli4 WANG Jinbang3 QI Liqing3. Clinical effect of closed reduction combined with external fixaton in the treatment of intertrochanteric fracture of femur in high risk elderly. 中国医药导报, 2018, 15(6): 63-66.
[1] 刘利民,沈惠良,高志华.老年股骨粗隆间骨质疏松性骨折外固定术[J].中国骨与关节损伤杂志,2006,21(10):778-780.
[2] Cummings SR,Melton IJ. Epidenmiology and outcomes of osteoporotic fractures. Lancet [J]. 2002,359(9313):1761-1767.
[3] 田伟.积水潭使用骨科学[M].北京:人民卫生出版社,2008.
[4] 刘沂,史立强.髋关节骨折脱位临床指南[M].北京:人民军医出版社,2010.
[5] 国家中医药管理局.中医病症诊断疗效标准[S].南京:南京大学出版社,1994.
[6] Mullerler ME,Nazarian S,Koch P. The Comprehensive Classification of Fractures of the Long Bones [J]. New York Springer-Verlag,1990:118.
[7] Harris WH. Traumatic arthritis of the hip after dislocation and acetabularfracture:treatment by mold arthroplasty. An end-result study using a new method of result evaluation [J]. J bone Joint Surg(Am),1969,51(4):737-755.
[8] 胡敏,张红印.带空心螺纹针外固定架治疗股骨粗隆间骨折[J].骨与关节损伤杂志,2003,18(1):49-50.
[9] 谢学然,夏志锋.闭合复位外固定架固定治疗股骨粗隆间骨折[J].生物骨科材料与临床研究,2005,2(6):42-43.
[10] 祁振良,李俊龙.骨外固定架治疗股骨粗隆间骨折[J].实用骨科杂志,2004,10(5):477-478.
[11] Atici T,Sahin N,Oztürk A,et al. Treatment of intertrochanteric femur fractures in high-risk geriatric patients(≥65 years)with external fixation [J]. Ulus Travma Acil Cerrahi Derg,2010,16(5):413-420.
[12] Gotfried Y,Frish E,Mendes DG,et al. Intertrochanteric fractures in high risk geriatric patients treated by externalfixation [J]. Orthopedics,1985,8(6):769-774.
[13] 孙贵耀,张雪华,乔晓光,等.老年股骨粗隆间骨折骨折病的相关临床研究[J].中国矫形外科杂志,2010,1(4):10.
[14] 张志刚,余峰,刘锦涛.两种方法治疗老年性股骨粗隆间骨折疗效对比分析[J].湖南中医杂志,2011,27(6):51.
[15] 黄五京.交叉穿针外固定架固定治疗老年股骨粗隆间骨折42例临床体会[J].中国现代医生,2009,47(15):235-236.
[16] 薛海燕,王宸,李贺.不同方式治疗股骨转子间骨折[J].中国矫形外科杂志,2015,23(12):1108-1111.
[17] Efstathopoulos NE,Nikolaou VS,Lazarettos JT. Intramedullary fixation of intertrochanteric hip fractures:a comparison of two implant designs [J]. Int Orthop,2007,31(1):71-76.
[18] He W,Zhang W. The curative effect comparison between prolonged third generation of gamma nail and prolonged dynamic hip screw internal fixation in treating femoral intertrochanteric fracture and the effect on infection [J]. Cell Biochem Biophys,2015,71(2):695-699.
[19] Shi X,Zhou Z,Yang J,et al. Total hip arthroplasty using non-modu-larcementless long-stem distal fixation for salvage of failed internal fixation of intertrochanteric fracture [J]. J Arthroplasty,2015,30(11):1999-2003.
[20] 宋斌.闭合复位外固定架固定术治疗高龄股骨粗隆间骨折的体会[J].河南外科学杂志,2013,19(4):45-46.