人工股骨头置换及内固定治疗股骨粗隆间骨折疗效对比探究.docVIP

人工股骨头置换及内固定治疗股骨粗隆间骨折疗效对比探究[摘要] 目的 研究分析人工股骨头置换与内固定治疗粉碎性股骨粗隆间骨折的疗效。方法 78例股骨粗隆间骨折患者随机分组，其中39例应用人工股骨头置换治疗，设立为观察组，39例以动力髋螺钉（DHS）和PFNA内固定治疗，设立为对照组，对比分析人工股骨头置换治疗股骨粗隆间骨折与DHS、PFNA治疗的效果。结果 与对照组比较，观察组的手术时间短，术中出血少，患者下床活动早，住院时间短，术后并发症发生率低，髋关节功能优良率高（P＜0.05或P＜0.01）。结论 人工股骨头置换术治疗粉碎性股骨粗隆间骨折具有操作方便、手术时间短、出血少、术后下床活动早、并发症少的优点；避免了二次内固定取出的手术痛苦，优于内固定，值得推广和应用。 [关键词] 股骨粗隆间骨折；人工股骨头置换；动力髋螺钉；股骨近端髓内钉 [中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2011）25-50-02 Comparative Study on Hemiarthroplasty and Internal Fixation of Intertrochanteric Fractures TANG HaijunCHENG WenNI Zengliang Zhejiang Province Lanxi City People’s Hospital，Lanxi 321100，China [Abstract] Objective To study and analysis the effect of hemiarthroplasty and internal fixation of intertrochanteric fractures. Methods All 78 cases intertrochanteric fractures were randomly divided into two groups，of which 39 patients were treated with hemiarthroplasty treatment，the establishment of the observation group，39 cases with DHS fixation，the establishment of the control group，comparative analysis of artificial stock bone replacement in the treatment of intertrochanteric fracture with the DHS benefits. Results Compared with control group，the observation group of shorter operative time，less blood loss，patients with early ambulation，shorter hospital stay，postoperative complication rate，excellent high rate of hip function，and compared two sets of these indicators，the difference was statistically significant（P＜0.05 or P＜0.01）. Conclusion Hemiarthroplasty treatment of intertrochanteric fractures with easy operation，short operative time，less bleeding；After getting out of bed early，fewer complications benefits；Avoid secondary fixation surgery removed the pain，is better than the dynamic hip screw fixation，should be promoted and applied. [Key words] Intertrochanteric fractures；Hemiarthroplasty；Dynamic hip screw；PFNA 股骨粗隆间骨折多见于老年人，尤其高龄老年人常伴有明显的骨质疏松症，加之不稳定骨折本身的影响，虽然内固定能较好地维持骨愈合和其所必须的稳定的需要，但必须考虑操作简单及缩短手术时间[1]。且临床实践发现，内固定常不能获得满意的疗效。人工关节置