锁定钢板与关节置换治疗高龄不稳定股骨转子间骨折比较  

Study on Locking Plate and Joint Replacement in the Treatment of Unstable Intertrochanteric Fractures in the Elderly

作　　者：周伟[1] 贺学军[1] 易惠军[1] 

机构地区：[1]湖南省马王堆医院骨科,中国长沙410016

出　　处：《国际老年医学杂志》2015年第3期115-118,121,共5页International Journal of Geriatrics

摘　　要：目的：比较锁定钢板内固定与人工髋关节置换治疗高龄不稳定性股骨转子问骨折的治疗效果、并发症发生情况。方法：回顾性分析53例股骨转子间骨折患者，根据手术方法分为锁定钢板内固定组、关节置换组。术后1个月、3个月、6个月、12个月时分别随访患者髋关节功能、日常生活活动能力、并发症发生情况。对患者术后髋关节功能、日常生活活动能力Barthel指数评分、并发症发生情况对比分析。结果：两组患者在非内置物相关并发症、内置物相关并发症及总并发症的发生率上差异无统计学意义（P〉0．05）。关节置换组患者在术后1个月、3个月、6个月、12个月时髋关节Harris评分均高于锁定钢板内固定组，差异有统计学意义（P〈0．05）。关节置换组患者在术后1个月、3个月、6个月时Bar—thel指数评分均高于锁定钢板内固定组，两组差异有统计学意义（P〈0．05）；然而在术后12个月时关节置换组患者Barthel指数评分稍高于锁定钢板内固定组，两组差异无统计学意义（P〉0．05）。结论：治疗高龄不稳定性股骨转子间骨折，人工关节置换在术后早期能够获得更好的髋关节功能及更好的日常生活活动能力。OBJECTIVE ： To discuss the therapeutic effect of locking plate internal fixation and artificial hip joint replacement in the treatment of unstable intertroehanteric fractures in the elderly. METHODS： 53 patients were analysed retrospectively. They were divided into locking plate internal fixation group and the joint replacement group according to different surgical methods. After surgery for 1 month, 3 months, 6 months and 12 months, the hip joint functions, capability of daily living activities and occurrence of com- plications in patients were followed up. A comparative analysis was conducted on the data of preoperative general conditions, postoper- ative hip joint functions, Barthel index score on the capability of daily living activities, and the occurrence of complications. RE- SULTS： After surgery for 1 month, 3 months, 6 months and 12 months, the Harris scores of hip joint in the joint replacement group were higher than those in the locking plate internal fixation group. There were statistically significant differences （ P 〈 0. 05 ）. After surgery for 1 month, 3 months and 6 months, the Barthel index scores in the joint replacement group were higher than those in the loc- king plate internal fixation group. There were statistically significant differences （ P 〈 0.05 ）. However after surgery for 12 months, the Barthel index score in the joint replacement group was slightly higher than that in the locking plate internal fixation group. There was no statistically significant difference （ P 〉 0. 05 ）. CONCLUSION ： The artificial joint replacement for treatment of unstable inter- trochanteric fractures in the elderly patients can achieve better hip joint functions and capability of daily living activities in the postoperative early period.

关 键 词：股骨转子间骨折 锁定钢板 关节成形术 内固定术 髋 

分 类 号：R683.42[医药卫生—骨科学]