双极股骨头置换与解剖钢板内固定治疗高龄不稳定型股骨粗隆间骨折的疗效评价  

Comparison of Bipolar Arthroplasties and Anatomical Plate Fixation for the Treatment of Unstable Femoral Intertrochanteric Fractures in Elderly Patients

作　　者：王智[1] 周雪明[1] 何淑贞[1] 

机构地区：[1]东莞市人民医院普济院区骨科,广东东莞523000

出　　处：《河南职工医学院学报》2012年第3期279-282,共4页Journal of Henan Medical College For Staff and Workers

基　　金：2011年东莞市科技计划医疗卫生类科研项目;项目编号:201110515001107

摘　　要：目的比较双极股骨头置换与解剖钢板内固定高龄不稳定型股骨粗隆间骨折的疗效,探讨高龄不稳定型股骨粗隆间骨折的合理治疗方法。方法回顾性分析2006年7月～2010年4月间接受治疗的高龄股骨粗隆间骨折52例,骨水泥双极股骨头置换组29例,解剖钢板内固定组23例。比较两种治疗方法的切口长度、手术时间、术中出血量、输血量、术后卧床时间、内科并发症、内植物并发症、术后关节功能状况等。结果与解剖钢板内固定组相比较,双极股骨头置换组手术时间、术后卧床时间均较短,术中出血量、输血量、内科并发症较少(P<0.05),术后第1、3个月时髋关节功能股骨头置换组明显占优,但内植物并发症,术后的第6及12个月时髋关节功能恢复状况等差异不明显(P>0.05)。结论双极股骨头置换术与解剖钢板内固定术均是治疗高龄患者不稳定型股骨粗隆间骨折的有效方法。但前者在早期功能恢复,减少内科并发症方面具有优势。Objective To approach a reasonable treatment for unstable femoral intertrochanteric frac- tures in elderly patients by comparing the effects of bipolar arthroplasties and anatomical plate fixation. Methods Totally 52 elderly patients with femoral intertrochanteric fractures were treated from July 2006 to April 2010. In 52 patients, 29 were treated with bipolar arthroplasties, and 23 were treated with ana- tomical plate fixation. Comparison was made between the two groups in terms of operative incision length, operative time, blood transfusion during or after surgery, time for bed rest postoperatively, postoperativecomplications and Harris hip score in different stages after surgery（ 1,3,6,12 months）. Results Com- pared with the group of anatomical plate fixation, the group of bipolar arthroplasties experienced shorter time for operative time and bed rest postoperatively, fewer blood transfusion and postoperative complica- tions and higher Harris score 1 and 3 months after surgery（P 〈 0.05） , and the Harris score between the two groups had no statistical significance 6,12 months after surgery（P 〉 0.05）. Conclusion Both of the two methods are reasonable for unstable femoral intertrochanteric fractures in elderly patients. Bipolar arthroplasties has the advantages of allowing early full weight bearing after surgery,low complication rate and satisfactory functional recovery.

关 键 词：股骨头置换术 钢板内固定 股骨粗隆间骨折 不稳定型骨折 高龄患者 

分 类 号：R683.42[医药卫生—骨科学]