动力髋螺钉与人工关节置换治疗高龄股骨转子间骨折疗效比较  

Clinical comparison between hemiarthroplasty and dynamic hip screw for elderly patients with femoral intertrochanteric fracture

作　　者：司全明[1] 毛宾尧[1] 王毳[1] 任强[1] 

机构地区：[1]宁波市第一医院骨科,浙江宁波315010

出　　处：《临床骨科杂志》2008年第1期29-31,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨动力髋螺钉(DHS)内固定与人工关节置换术治疗高龄股骨转子间骨折的方法及治疗效果。方法66例高龄不稳定股骨转子间骨折患者随机分为2组,DHS内固定治疗35例,人工股骨头置换治疗31例。比较2组术后并发症及髋关节功能。结果60例获随访,时间8个月～6年,随访期内死亡5例。并发症:关节组发生3例,DHS组发生12例,差异有显著性(P<0.05)。患髋功能评定采用Harris评分法:关节组72～95(84.5±5.4)分,DHS组68～91(82.1±6.8)分,差异无显著性(P>0.05)。结论对于年龄≥80岁、骨质疏松及不稳定股骨转子间骨折患者,采用人工股骨头置换治疗是可行的,远期效果仍需继续观察。Objective To assess the methods and clinical effects of hemiarthroplasty or dynamic hip screw（DHS） in elderly patients with unstable femoral intertrochanteric fracture. Methods 66 elderly cases with unstable femoral intertrochanteric fracture were randomly divided into two groups. 35 cases were treated with DHS, and 31 cases were treated with hemiarthroplasty. The hip function and postoperative complications were compared between the two groups. Results 60 cases were followed up for 8 months to 6 years. 5 cases died in the following up periods. The difference between two groups on postoperative complications which occurred in 3 cases in hemiarthroplasty group and 12 cases in DHS group was significant（ P 〈 0. 05 ）. The hip function according to Harris Scores was 72 - 95 （ 84. 5 ± 5.4） scores in hemiarthroplasty group ,68-91 （82. 1 ± 6. 8 ）scores in DHS group. There was no significant difference on the hip function between two groups （ P 〉 0. 05 ）. Conclusions Hemiarthroplasty is a proper selection for patients aged≥80 years old with osteoporosis and unstable femoral intertrochanteric fracture. The long-term results should be further followed up.

关 键 词：股骨转子间骨折 动力髋螺钉 髋关节置换 老年人 

分 类 号：R683.42[医药卫生—骨科学] R687.42[医药卫生—外科学]