关键词: 股骨转子间, 骨折, 外固定术

Abstract: Objective To evaluate the results of the treatment of intertrochanteric fractures of the femur with external fixation in 56 patients with an average age of 66.3 from 1996 to 2004,to find out the best surgical pattern and define the indication of external fixation for intertrochanteric fractures.Methods Closed reductions were performed with 3 Steinman's pins inserted into the head and neck of femur by simulating the orientation of bone trabecula and 2 semi-spiral pins into the proximal femur to make an irregular quadrangle.Results All patients except one in the study had Evans unstable type Ⅲ,Ⅳ intertrochanteric fractures.The average follow-up period in 40 patients was 17.7 months(ranging from 6 to 36 months)and the time for fracture union was 12.3 weeks(ranging from 7 to16 weeks).48 cases could be reduced to anatomical,8 cases to nearly anatomical position by closed manipulation under fluoroscopy.No case was dead in hospital.6 out of 40 patients died in following-up period,and one patient died after six months following the surgery.No uncontrolled deep pin-tract infection,no broken pin?falling off pin?head cutout or secondary varus malalignment occurred in these cases.Conclusion Compared with conservative or internal fixation treatment,it has such advantages as minimal surgical trauma,less bleeding,no need for transfusion,short operation time and simple manipulation;Crossed pins inserted into the head and neck overcome the shortages of local force fixation with one pin in internal fixation.Therefore,it extended the operation indications,and it is a valuable alternative in the treatment of high-risk geriatric patients,especially those unable to stand internal fixation.

Key words: intertrochanteric, fractures, external fixation