高龄股骨粗隆间不稳定骨折两种手术疗效比较  

Efficitive comparison on elderly patients with hemiarthroplasty and internal fixation of intertro-chanteric unstable fractures

作　　者：郭程亮 吴双芝 莱安平 李迎利 

机构地区：[1]山西省汾阳医院骨科,032200

出　　处：《中国实用医刊》2013年第6期71-73,共3页Chinese Journal of Practical Medicine

摘　　要：目的比较加长柄双极双动股骨头置换与动力加压螺钉（DHS）内固定术治疗高龄患者粗隆间不稳定骨折（EvansIII、IV、V型）的疗效。方法将101例高龄粗隆间不稳定骨折患者随机分为两组，关节置换组45例，采用加长柄双极双动股骨头置换治疗，内固定组56例，采用DHS螺钉内固定，比较两组患者手术时间、术中出血量、术中X线暴露次数、术后恢复负重时间、术后再手术率及术后关节功能恢复情况等。结果股骨头置换组与内固定组在手术时间、术中出血量、关节功能恢复比较差异无统计学意义（P〉0．05），但两组在术后康复时间、手术失败再手术x线暴露次数方面比较差异有统计学意义（P〈0．05）。结论治疗高龄股骨粗隆间不稳定骨折加长柄股骨头置换术优于DHS螺钉内固定术。Objective To compare efficacy of plus skillet bipolar double-action femoral head replacement and the DHS screw fixation in elderly patients with intertrochanteric unstable fracture （Evans III, IV, V type）. Methods One hundred and one patients with intertrochanteric fractures were ran- domly divided into two groups： 45 patients in femoral head replacement group were treated with plus skillet bipolar double-action femoral head replacement treatment, 56 patients in the internal fixation group with DHS screw fixation treatment, to compare the differences of the operative time, blood loss, intraoperative X-ray exposure times, the postoperative recovery load time, postoperative reoperation rate and postoperative joint function recovery between the two groups. Results The difference was not statistically significant （P 〉 0.05 ） in operative time, blood loss, joint function recovery between femoral head replacement group and internal fixation group, but the difference was statistically significant （P 〈 0. 05 ） in postoperative recovery time, surgery fails, surgical X-ray exposure times between the two groups. Conclusions Plus skillet femoral head arthroplasty is better than DHS screw internal fixation for elderly patients with intertrochanteric unstable fracture.

关 键 词：高龄 股骨粗隆间不稳定骨折 股骨头置换 动力加压螺钉内固定 

分 类 号：R687.3[医药卫生—骨科学]