[摘要] 目的 探讨高龄患者股骨粗隆间骨折的手术方法及疗效。方法 对2003年1月～2006年2月收治的高龄(75岁以上)股骨粗隆间骨折44例患者进行手术治疗。其中男15例,女29例,年龄75～93岁,90岁以上4例,平均年龄82岁。44例中有38例合并有内科疾病,占病例总数的86.3%。44例均采用Gamma钉内固定治疗。结果 44例病例经围术期准备后均顺利进行了手术,术后死亡1例,余43例均得到随访。随访时间5～18个月,平均11个月。骨折全部愈合,愈合时间3～6个月。无明显髋内翻及下肢短缩畸形，无感染,无Gamma钉断裂、退钉。患肢关节功能优良率93%。结论 高龄股骨粗隆间骨折患者常合并多种内科疾病,身体状况差,对手术耐受性也较差。Gamma钉具有手术操作简单、时间短、固定牢靠、损伤小、出血少、骨折愈合率高等优点,适合高龄股骨粗隆间骨折患者的手术要求,是一种值得临床推广的手术方法。

    [关键词] 股骨粗隆间骨折；高龄患者；内固定术

    Surgical experiences of the femoral intertrochanteric fractures of the aged people

    LI Fan,HUANG Jian-hua,TAO Jie,et al.Department of Orthopaedics,Shanghai First People’s Hospital,Shanghai 200080,China

    [Abstract] Objective To discuss the surgical method and efficacy of the femoral intertrochanteric fractures of the aged people.Methods From Jan,2003 to Feb,2006,44 patients (more than 75 yrs) with the femoral intertrochanteric fractures were surgically treated.Among them,there were 15 male and 29 female patients,and the age range varied from 75 to 93 yrs (the average age was 82 yrs,also 4 patients was more than 90 yrs).38 patients (about 86.3%) of all accompanied by other internal medical disorders,and the treatment of all 44 patients were selected with Gamma nails.Results After peri-operative preparations,44 patients were successfully operated. But one patients died after operation, and other 43 patients were followed up for 5 to 18 months post-operations(mean time was 11 months).The fractures of 43 patients with femoral intertrochanteric fractures were healed between 3 to 6 months after operations.Meanwhile,there were no complications occurred:such as hip varus,shortening of lower extramity, infections,break of Gamma nails,or withdraw of nails.The functions of hip joints was excellent and good at the ratio of 93%.Conclusion The aged people with the femoral intertrochanteric fractures usually accompanied with several internal medical disorders,and their general conditions were poor and the tolerance of operations was not good.However,the techniques of Gamma nails was simple,with short time,of firm fixation,minimal injury,less bleedings, and with high ratio of bony healing.So it was very suitable for the femoral intertrochanteric fracture of the aged people,and worthful for recommendation of surgery. ......