人工双动股骨头置换与PFNA内固定治疗高龄股骨粗隆间骨折  

Comparison of artificially double-acting avascular replacement and PFNA internal fixation for intertrochanteric fractures in elderly patients

作　　者：李奕标[1] 蔡瑞歆[1] 程培楷[1] 黄维[1] 

机构地区：[1]潮州市中心医院骨科,广东潮州521000

出　　处：《局解手术学杂志》2016年第9期680-683,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨人工双动股骨头置换与股骨近端防旋髓內钉(PFNA)内固定治疗高龄不稳定型股骨粗隆间骨折患者的临床疗效。方法回顾性分析2013年8月至2014年8月我院收治的79例高龄不稳定型股骨粗隆间骨折患者的临床资料,根据手术方式不同分成观察组40例和对照组39例。观察组采用人工双动股骨头置换术治疗,对照组采用PFNA内固定术。观察记录并比较2组手术时间、术中出血量、卧床时间、临床疗效、并发症发生情况。结果观察组患者手术时间和卧床时间均明显短于对照组患者,差异有统计学意义(P<0.05)。观察组患者术后总并发症发生率为20.00%,对照组为20.51%,2组比较差异无统计学意义(P>0.05)。观察组患者术后3个月和6个月时Harris评分均明显高于对照组,差异有统计学意义(P<0.05)。结论人工双动股骨头置换术和PFNA内固定术治疗高龄不稳定型股骨粗隆间骨折患者临床疗效均较好,但人工双动股骨头置换术术中出血量少,术后恢复快且并发症少,更有利于提高患者生活质量。Objective To observe the clinical efficacy of bipolar hemi arthroplasty and PFNA internal fixation for elderly patients with unstable intertrochanteric fracture.Methods The data of 79 elderly patients with unstable intertrochanteric fracture in our hospital from Au-gust 2013 to August 2014 were analyzed retrospectively.According to different surgical methods,79 cases were divided into observation group （n =40）and control group（n =39）.The observation group were treated by artificially double-acting avascular replacement,and the control group received PFNA internal fixation.The operation time,intraoperatve blood soss,bedridden time,clinical effecacy and complications were recorded and observed.Results The operative time and bed time of observation group were significantly shorter than those of control group, the difference was statistically significant（P 〈0.05）.The total postoperative complication rate of observation group was 20.00%,which was higher than 20.51% of control group,the difference was statistically significant （P 〈0.05）.The Harris scores in observation group 3 months and 6 months after surgery were significantly higher than those in control group,the differences were statistically significant（P 〈0.05）.Con-clusion Both artificially double-acting avascular replacement and PFNA internal fixation have a good effect on elderly patients with unstable intertrochanteric fracture.The artificially double-acting avascular replacement has the advantages of less blood loss,faster recovery and less postoperative complications,which is conducive to improving the quality of life of patients.

关 键 词：股骨粗隆间骨折 人工股骨头 骨折固定术 髋关节置换术 骨质疏松 

分 类 号：R687.3[医药卫生—骨科学]