[摘要] 目的 探讨骨质疏松性髋部骨折的手术治疗方法及临床疗效。方法 2000年1月~2005年3月采用外科手术治疗骨质疏松性髋部骨折107例，男43例，女64例；年龄54~91岁，平均78.47岁；股骨粗隆间骨折46例，男19例，女27例；年龄54~91岁，平均78.4岁，方法：DHS内固定41例，空心加压螺钉固定3例，人工股骨头置换1例，Gamma钉内固定1例。按Evans分型，Ⅰ型3例，Ⅱ型10例，Ⅲ型31例，Ⅳ型2例。股骨颈骨折61例，男24例，女37例；年龄62~91岁，平均78.52岁，按分Garden分型，Ⅰ型4例，Ⅱ型12例，Ⅲ型19例，Ⅳ型26例。人工股骨头置换44例，全髋关节置换2例，空心加压螺钉固定15例。结果 股骨粗隆间骨折39例随访，随访时间8~18个月，平均13个月，DHS平均愈合时间为4.6个月，有2例发生股骨钉的切割。1例发生手术感染，术后7天并发心肺功能衰竭死亡。股骨颈骨折53例随访，随访时间8~24个月，平均17个月；按Harris评分标准：优30例，良18例，中15例，优良率为90.55%。结论 对于骨质疏松性髋部骨折，采用手术治疗可以取得满意疗效。

    [关键词] 骨质疏松；髋部关节；外科手术

    Operation treatment of hip fracture in elderly osteoporotic patients

    SUN Chang-hui,HUANG Jian.Department of Orthopaedics,Ruijin Hospital Luwan Branch,Shanghai Second Medical University,Shanghai 200020,China

    [Abstract] Objective To investigate the operation treatment for hip fracture in elderly osteoporotic patients.Methods 107 cases hip fracture were treated with operation methods,which involved 43 males and 64 females.(mean age 78.47 years;range 54~91 years).46 cases interchanteric fracture were treated;with involved 19 males and 27 females(mean age 78.41 years;range 54~91 years).All were divided with Evans type:3 in Ⅰ,10 in Ⅱ,31 in Ⅲ,2 in Ⅳ;DHS operation treatment in 41,hollow pull screw in 3,hip replacement in 1,61 cases with femur neck fracture were treated;which involved 24 males and 37 females(mean 78.52,range 62~91 years).All are divided with Garden type:4 in Ⅰ,12 in Ⅱ,19 in Ⅲ,26 in Ⅳ;hip replacement in 44,total hip replacement in 2,hollow pull screw in 15.Results 39 patients with interchanteric fracture were followed-up for 8~18 months with a mean of 13 months.In DHS group,the average fracture healing time was 4.6 months.In 2 cases screw cutting was occurred.1 case with infection was dead for heart and lung fracture in 7 days after operation,53 patients with femur neck fracture were followed-up for 8~24 months with a mean of 17 months.According to Harris scoring system,30 were assessed as excellent,good 18,fair 5,and the excellent-good rate was 90.55%.Conclusion Operation can get better results in hip fracture with osteoporosis. ......