两种方式治疗股骨粗隆间骨折的疗效分析
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【摘要】目的：本文对资料完整，随访三年的老年股骨粗隆间骨折的患者进行回顾性研究，对经以中医正骨手法闭式复位，外固定治疗为主的疗法和西医切开复位，内固定手术治疗后的结果进行客观评价，为临床上股骨粗隆间骨折的治疗提供参考。方法：选取于我院经以中医正骨手法闭式复位，外固定治疗或西医切开复位，内固定手术治疗，随访三年，病历及影像资料完整，老年股骨粗隆间骨折患者作为研究对象，将病人按治疗方法分为：中医正骨手法复位外固定治疗、西医切开复位，内固定手术。观察病人经以上两种方法治疗后的随访三年以上的治疗结果，应用harris评分评分标准进行评分，并通过影象学、步态分析测定观察病人的恢复情况。结果：中医正骨手法复位外固定治疗，骨折按Evans分类：Ⅰ型1例，Ⅱ型11例，Ⅲ型17例，Ⅳ型1例。harris评分80.14±1.21。西医切开复位，内固定治疗骨折按Evans分类：Ⅰ型1例，Ⅱ型9例，Ⅲ型19例，Ⅳ型2例。 harris评分72.34±1.47。结论：如适应症选择得当，经中医正骨手法复位外固定治疗的高龄老年股骨粗隆间骨折的患者较其他疗法具有优势。其疗效好，并发症少，安全系数高，经济费用低，手术操作时间短，较西医手术治疗老年患者更易于接受，且卧床时间明显短于保守治疗，易于早期锻炼。
【关键词】老年股骨粗隆间骨折外固定治疗 内固定治疗
【Abstract】Objective: This text is intact to the materials, the patient following up a case by regular visits to intertrochanter fracture of the old femur for three years carries on reviewing research.this retrospective study was made through an objective valuation of results of various therapies for cases treated.Method:The definite intertrochanteric fractures of the old femur cases .which were treated in our hospital in fixed operative and which were treaded in external fixation apparatus method three years ago.were carefully selected for this study.The medical records and image materials of the patients were all intact.And,they were all very cooperative .The patiebts were divided into tow group: in fixed operative group and external fixation apparatus group.The three years therapeutic effects and image change ofthe tow groups were observed.The therapeutic effects were valued by harris criterion and analyticl system of gait test. The data were analyzed statistically by ridit-analysis and T-test.Results:The treaded in external fixation apparatus group , fracture is classified by Evans: Ⅰ型1 case，Ⅱ型11 cases, Ⅲ型17cases,Ⅳ型1 case。harris grade 80.14±1.21.the treaded in DHS group , fracture is classified by Evans: Ⅰ型1 case，Ⅱ型9 cases, Ⅲ型19cases,Ⅳ型2 case。harris grade72.34±1.47。Conclusions:If indication choose properly,the intertrochanteric fractures of the old femur teated by in external fixation apparatus method that treated other treatments have advantages. Its curative effect is good, there are few complications, safety coefficient is high, the economic expenses are low, the operating time of operation is short, treat the old patient to accept more readil ......
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