学术论文

      老年人股骨转子间骨折闭合复位内固定术后内固定失败的影响因素分析

      Analysis of influencing factors of failure of internal fixation after closed reduction and internal fixation for intertrochanteric fractures in the elderly

      摘要:
      目的:探讨老年股骨转子间骨折患者手术失败的相关因素,为临床治疗提供依据。方法100例老年股骨转子间骨折患者均予以闭合复位内固定术治疗,分析导致其手术失败的相关因素。结果100例患者中内固定失败患者共7例。4~6级的 Singh 指数、并发基础疾病、尖顶距(TAD)>25 mm 且使用激素药物患者的内固定失败率显著高于1~3级的 Singh 指数、无基础病、TAD 不足25 mm,且未使用激素治疗的患者,差异均有统计学意义(χ2=6.246、4.532、4.532、6.439,均 P <0.05)。患者的骨折类型、Singh 指数、并发基础病、TAD >25 mm 及 Cleveland 分区均可作为内固定失败的风险因素,差异均有统计学意义(均 P <0.05)。结论应用闭合复位内固定术治疗老年股骨转子间骨折患者,患者的骨折类型、Singh 指数、并发基础疾病、TAD >25 mm 及 Cleveland 分区均可作为内固定失败的风险因素。
      Abstract:
      Objective To explore the process of clinical treatment of senile intertrochanteric fractures in patients with closed reduction and internal fixation,to analyze the related factors leading to operation failure,and to lay the foundation for the clinical treatment in Department of Orthopedics.Methods 100 elderly patients with intertro-chanteric fracture were treated with closed reduction and internal fixation,and the related factors leading to the failure of the operation were analyzed.Results Through the statistics of all patients,7 cases were found in patients with internal fixation failure.The internal fixation failure rates of the patients with 4 ~6 class Singh index,basic diseases, TAD >25mm,and the using of hormone drugs were significantly higher than those of the patients with 1 -3 class Singh index,basic diseases,TAD≤25mm,and no using hormone drugs,the differences were statistically significant (χ2 =6.246,4.532,4.532,6.439,all P <0.05).And the fracture type,Singh index,basic diseases,TAD >25mm and Cleveland partition were internal fixation failure risk factors,the difference was statistically significant(all P <0.05).Conclusion In the application of closed reduction and internal fixation for the treatment of intertrochanteric fractures in the elderly patients,the fracture type,Singh index,basic disease,TAD >25mm and Cleveland partition can be used as the risk factors of internal fixation failure.
      作者: 蔚晋斌
      Author: Wei Jinbin
      作者单位: 山西省人民医院骨科, 山西省太原,030012
      刊 名: 中国基层医药 ISTIC
      年,卷(期): 2017, 24(6)
      在线出版日期: 2017年3月29日