普通型骨水泥股骨头假体置换与内固定治疗老年股骨粗隆间粉碎性骨折的对比研究  

Comparison of common bone-cement artificial femoral head replacement versus internal fixation for treatment of comminuted femoral intertrochanteric fractures in the aged patients

作　　者：杨伟兵[1] 户刚[1] 张勇智[1] 王青平[1] 阮文辉[1] 刘志国[1] 

机构地区：[1]汉中市中心医院骨关节创伤科,陕西723000

出　　处：《中国骨与关节损伤杂志》2017年第2期137-140,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨普通型骨水泥股骨头假体置换和锁定加压钢板(LCP)、股骨近端防旋髓内钉(PFNA)内固定在治疗老年股骨粗隆间粉碎性骨折中的临床疗效比较。方法笔者自2010-01—2014-01诊治90例老年股骨粗隆间粉碎性骨折,根据手术方式的不同分为关节置换组、LCP组和PFNA组,观察手术时间、术中出血量、下地行走时间、并发症发生率等指标。结果 3组手术时间比较差异无统计学意义(P>0.05);置换组术中出血量明显低于LCP组,差异有统计学意义(P<0.05),与PFNA组相比差异无统计学意义(P>0.05);关节置换组术后下地行走时间及术后并发症发生率明显优于LCP组及PFNA组,差异有统计学意义(P<0.05);术后1、3个月时置换组髋关节Harris评分显著高于LCP组及PFNA组,差异有统计学意义(P<0.05),术后6个月置换组髋关节Harris评分显著高于LCP组,差异有统计学意义(P>0.05),但与PFNA组相比差异无统计学意义(P>0.05),术后12个月时3组髋关节Harris评分相比差异无统计学意义(P>0.05)。结论普通型骨水泥股骨头假体置换治疗老年股骨粗隆间粉碎性骨折是一种相对安全、有效、简单的手术方法,在减少术后并发症、缩短治疗周期、改善患者生活质量方面疗效显著。Objective To compare the clinical effect of common bone-cement artificial femoral head replacement and internal fixation as locking compression plate （LCP）, proximal femoral rotation intramedullary nail （PFNA） in the treatment of femoral intertrochanteric fractures in old patients. Methods Ninety aged patients with comminuted femoral intertrochanteric fractures from January 2010 to January 2014 were selected and divided into three groups： hip replacement group, locking compression plate group （LCP group） and proximal femoral nail anti-rotation group （PFNA group）. The operation time, the intraoperative blood loss, weight-bearing time after operation, incidence of surgical complication, etc were evaluated by statistical analysis. Results There was no significant difference in operation time among the three groups （P 〉0.05）. The volume of bleeding of hip replacement group was lower than that of LCP group （P 〈0.05）, but there was no significant difference between hip replacement group and PFNA group （P 〉0.05）. The weight-bearing time after operation and the incidence of surgical complication of hip replacement group were obviously superior to the other two groups, the differences were statistically significant （P 〈0.05）. The Harris scores of hip replacement group was significantly greater than that of LCP group and PFNA group at 1 month and 3 month after operation （P 〈0.05）, at 6 month after operation the Harris scores of hip replacement group was higher than that of LCP group （P 〈0.05）, but there was no significant difference compared with PFNA group（P 〉0.05）, there were no significant difference among three groups at 12 month（P 〉0.05）. Conclusion Common bone- cement artificial femoral head replacement should be considered as a safe, feasible and simple therapy for comminuted femoral intertrochanteric fractures of the aged patients. It can effectively reduce the postoperative complications, shorten the treatment cycle and improve living quality of pat

关 键 词：股骨粗隆间骨折 粉碎性骨折 人工股骨头置换术 锁定加压钢板 股骨近端防旋髓内钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]