2种方法治疗高龄患者股骨粗隆间骨折手术的疗效比较  

The curative effect comparision of two surgical technique in the treatment of intertrochanteric fracture of elderly patient

作　　者：秦骥[1] 廖亮[1] 王开明[1] 

机构地区：[1]安徽省蚌埠市第三人民医院骨科,233000

出　　处：《蚌埠医学院学报》2015年第9期1196-1198,共3页Journal of Bengbu Medical College

摘　　要：目的:比较2种手术方法治疗高龄患者股骨粗隆间骨折的疗效。方法:股骨粗隆间骨折高龄患者(≥76岁)22例,分别采用切开复位内固定术(锁定解剖钢板或股骨近端髓内钉)(内固定组)和股骨头置换术(置换组)治疗各11例。比较2组患者术中出血量、手术时间、住院时间和卧床时间,随访骨折愈合时间及不良反应发生情况,按照Harris髋关节评分系统评价术后功能恢复情况,并计算各组优良率。结果:随访2组患者骨折均愈合。2组患者术中出血量和手术时间差异均无统计学意义(P>0.05),内固定组患者住院和卧床时间均长于置换组(P<0.05和P<0.01)。内固定组:优7例,良3例,可1例,差0例,优良率90.9%,置换组:优9例,良1例,可1例,差0例,优良率90.9%。结论:2种手术方法均可获得满意临床效果,应根据股骨粗隆间骨折稳定程度和患者身体状况选择恰当的手术方式。Objective：To compare the curative effects of two surgical technique in the treatment of intertrochanteric fracture of elderly patient. Methods：Twenty-two elderly patients（age more than or equal to 76 years） with intertrochanteric fractures were treated with open reduction and internal fixation（locking anatomic plate or proximal femoral nail）（11 cases）,and femoral head arthroplasty（11 cases） . The intraoperative bleeding volume, operation time, hospitalization time and bed time, healing time of fracture and adverse reactions between two groups were compared. The postoperative functional recovery in all cases were evaluated using Harris Score system,the excellent and good rate of each group was calculated. Results：The femoral intertrochanteric fractures in 22 patients healed during the following period. The differences of intraoperative bleeding volume and operation time between two groups were not statistical significance（P〉0. 05）. The hospitalization time and bed time in internal fixation group were longer than those in femoral head arthroplasty group（P〈0. 05 and P〈0. 01）. Excellent in 7 cases,good in 3 cases,fair in 1 case and no error case in internal fixation group were found,the excellent and good rate of which was 90. 9%. Excellent in 9 cases,good in 1 case and fair in 1 case in femoral head arthroplasty group were found,the excellent and good rate of which was 90. 9%. Conclusions：The clinical effects of two treatment methods are good,surgical method is selected according to the stability degree of the femoral intertrochanteric fracture and condition of patients.

关 键 词：股骨粗隆间骨折 高龄患者 内固定 髋假体 

分 类 号：R683[医药卫生—骨科学]