双动头置换与Intertan内固定治疗老年不稳定型股骨粗隆间骨折的疗效比较  

Clinical effect comparison of Intertan nails and bipolar hemiarthroplasty techniques in treatment for unstable intertrochanteric fracture in elderly patients

作　　者：徐玮[1] 孔荣[1] 方诗元[1] 禹德万[1] 李守民[1] 夏睿[1] 黄威[1] 王英明[1] 黄炎[1] 孙建皖[1] 王叙进[1] 姚刚[1] 

机构地区：[1]安徽医科大学附属省立医院骨一科,安徽合肥230001

出　　处：《中国矫形外科杂志》2015年第8期687-691,共5页Orthopedic Journal of China

摘　　要：[目的]比较双动头置换与Intertan内固定治疗老年不稳定型股骨粗隆间骨折的临床疗效。[方法]对本院自2011年7月~2013年7月41例股骨粗隆间骨折患者,经随机分组分别采用双动头置换与Intertan内固定治疗,比较两组的术后血红蛋白浓度、术前术后输血量、手术时间、住院时间、术后完全负重时间、术中及术后并发症情况、死亡率及髋关节Harris评分（HHS）。[结果]本组全部病例术后随访13~15个月。两组术后血红蛋白下降值、术前术后输血量、住院时间、术后1年HHS评分、术后并发症发生率及死亡率均无明显差异（P〉0.05）,双动头置换组的手术时间和术后完全负重时间较Intertan内固定组明显缩短（P〈0.05）。[结论]在老年不稳定型股骨粗隆间骨折治疗方面,双动头置换与Intertan内固定都有着良好的疗效,但双动头置换在早期下地活动方面较Intertan内固定组有明显优势,是一种较好的手术方式。[Objective]To evaluate the clinical effect of Intertan and bipolar hemiarthroplasty in treatment of unstable intertrochanteric fracture in elderly patients.[Method]From July 2011 to July 2013,41 patients with unstable intertrochanteric fracture were randomly divided into Intertan and bipolar groups.After treatment,the two groups were compared in relation to preoperative and postoperative Hgb and blood transfusion and operation time and days of hospital stay and time to full weight and complications and mortality rates,functional status using the Harris Hip Score（HHS）.[Result]All the 41 patients were followed up for 13-15 months.Intertan and bipolar groups were similar in preoperative and postoperative Hgb and blood transfusion and days of hospital stay and complications and mortality rates and Harris Hip Score（HHS）.But the operation time and time to full weight were significantly longer in Intertan group compared to in bipolar group（P〈0.05）.[Conclusion]Intertan nails and bipolar hemiarthroplasty techniques are both good choice for unstable intertrochanteric fracture in elderly patients.But bipolar hemiarthroplasty is better than Intertan nails in the shorter time to full weight.

关 键 词：股骨粗隆间骨折 双动头置换 Intertan内固定 骨质疏松 

分 类 号：R687.3[医药卫生—骨科学]