人工股骨头置换与PFN治疗老年不稳定型转子间骨折的临床疗效分析  

Clinical Assessment for Hemiarthroplasty and PFN for Unstable Intertrochanteric Hip Fractures in Aged Patients

作　　者：吴大鹏[1] 李康[1] 赵斌[1] 徐海斌[1] 

机构地区：[1]新乡医学院第一附属医院骨外科,河南卫辉453100

出　　处：《中国现代医生》2008年第34期9-10,26,F0003,共4页China Modern Doctor

摘　　要：目的比较老年不稳定型转子间骨折采用人工股骨头置换和股骨近端髓内钉固定的手术疗效。方法2003年1月～2008年1月治疗的60例不稳定型老年转子间骨折患者中,27例行人工股骨头置换,33例采用股骨近端髓内钉固定,并对手术资料、术后并发症及髋关节功能进行临床随访分析。结果与PFN组相比,人工股骨头置换组手术时间短、切口小,术中出血量及术后引流量少,骨折临床愈合时间短,且可早期下床负重而不增加术后并发症发生率。结论人工股骨头置换术治疗老年不稳定型转子间骨折创伤小、手术时间短、并发症少,是治疗老年不稳定型转子间骨折的理想方法之一。Objective To assess the merits and defects of hemiarthroplasty and PFN in treatment of unstable intertrochanteric hip fractures in aged patients by comparing five clinical factors, and to guide the clinical treatment. Methods From January 2003 to January 2008,60 aged patients with unstable intertrochanteric hip fractures were followed up. Hemiarthroplasty （group A,in 27 patients） and PFN internal -fixation （group B,in 33 patients） were included. The data in each group were collected for statistical analysis on the following aspects：the operative time, the blood loss, the time of initiation of exercise after operation, complications, and the excellent and good rate. Results The operative time was（88 ± 15 ） minutes in group A, and （118 ± 18） minutes in group B. The blood loss was （405 ± 186） mL in group A, and （610 ± 256） ml in group B. The time of initiation of exercise after operation was（ 13 ± 6.3 ） days in group A, and（68 ± 8.2） days in group B. The complications occurred in 3 patients in group A,and 6 patients in group B. The excellent and good rate was achieved in 25 patients in group A （92.59 % ）, and 23 patients in group B （81.81%）. There was significant difference between group A and group B. Conclusion The hemiarthroplasty is better than PFN internal fixation in treatment of unstable intertrochanteric hip fractures in aged patients with the advantages, such as the shorter operation time, the shorter time of exercise after operation,less complications and quicker recovery. It can be a rational option for treatment of unstable in-tertrochanteric hip fractures in aged patients

关 键 词：老年转子间骨折 人工股骨头置换 股骨近端髓内钉 

分 类 号：R683[医药卫生—骨科学]