人工股骨头置换与DHS内固定治疗高龄股骨粗隆间骨折疗效比较.docVIP

精品论文 参考文献 人工股骨头置换与DHS内固定治疗高龄股骨粗隆间骨折疗效比较 吴少坚 张志（广州医学院荔湾医院 510170） 【摘要】目的 评价人工股骨头置换术治疗高龄股骨粗隆间骨折的临床效果。 方法 对2008年10月-2011年10月分别采用人工股骨头置换术（关节置换组）和DHS内固定（DHS组）治疗的74例高龄股骨粗隆间骨折患者进行回顾性分析。结果 随访1～4年。DHS组手术时间、术中出血量明显少于关节置换组（Plt;0.05）。关节置换组术后下床负重时间明显早于DHS组（Plt;0.01）。两组术后Harris评分无明显差异(P＞0.05)，关节置换组的并发症发生率明显低于DHS组（Plt;0.05）。 结论 人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折有较好的近期疗效，可使患者早期下床活动，减少骨折并发症，提高患者生活质量，是高龄股骨粗隆间骨折一种可行的治疗方法。但应严格掌握手术适应征。 【关键词】股骨粗隆间骨折 DHS 人工股骨头置换术 【中图分类号】R687 【文献标识码】A 【文章编号】2095-1752（2013）23-0390-03 The comparative effectiveness of Hemiarthroplasty and dynamic hip screws in eldly intertrochanteric fracture Wushaojian Zhangzhi (Department of Orthopaedics,The Liwan hospital of Guangzhou Medical Collage,510170) 【Abstract】OBJECTIVE To evaluate the clinical effects of hemiarthroplasty in eldly intertrochanteric fracture.METHODS Among the elderly patients of intertrochanteric fracture who were treated in our hospital between October 2008 and October 2011, 74 cases are chosen randomly to prosthetic replacement group as “observed group” and DHS treated group as “control group”.RESULTS All cases are follow-up observed for 1-4 years. None was infected. All indexes were analyzed by SPSS 13.0. The operation time (Plt;0.05) and the bleeding volume (Plt;0.01) of DHS group was less than the prosthetic one with significant difference. For time of postoperative of weight-bearing, the observed group was earlier than that of control group, and there was a significant difference(Plt;0.01).When scored by Harris Standards, there was no significant difference(P＞0.05). Through following-up to visit the groups who had occurred complication, there was a significant difference(Plt;0.05).CONCLUSION Compared with DHS inernal fixation, the prosthetic replacement in the treatment of elderly unstable intertrochanteric fractures has a value in short-term therapeutic effects, which can allow patients to get out bed earlier for weight-bearing, a