瓦格纳型假体置换术治疗股骨转子间骨折(EvansⅣ型)近期临床疗效观察  

Short term effect of Wagner-type prosthesis replacement in the treatment of femoral intertrochanteric fracture(Evans type Ⅳ)

作　　者：史纪元[1] 武世勋[1] 刘时璋[1] 易智[1] 傅蔷 SHI Jiyuan;WU Shixun;LIU Shizhang(Department of Orthopedics,Shaanxi Provincial People’s Hospital,Xi’an 710068)

机构地区：[1]陕西省人民医院骨科,西安710068 [2]西安市儿童医院血液肿瘤科,西安710003

出　　处：《陕西医学杂志》2020年第12期1580-1583,共4页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2017SF-259)。

摘　　要：目的:对比瓦格纳型(生物型)假体置换术与内固定术治疗股骨转子间骨折(EvansⅣ型)的近期疗效。方法:选择74股骨转子间骨折(EvansⅣ型)患者为研究对象,按照简单随机分组法分为观察组和对照组,每组37例。观察组采用瓦格纳型(生物型)假体置换术治疗,对照组采用内固定术治疗。比较两组手术疗效、关节功能恢复情况及并发症发生情况。结果:观察组手术时长、术后下地时间均显著低于对照组,差异均具有统计学意义(P<0.05)。两组术后引流量和术中出血量比较,差异无统计学意义(P>0.05)。术前两组髋关节Harris评分及Singh指数比较均无统计学差异(P>0.05)。术后3、6个月两组髋关节Harris评分及Singh指数均较术前显著升高(P<0.05),且观察组髋关节Harris评分均显著高于对照组(P<0.05),但两组Singh指数比较均无统计学差异(P>0.05)。观察组并发症发生率与对照组比较无统计学差异(P>0.05)。结论:与内固定术相比,瓦格纳型(生物型)假体置换术治疗不稳定型EvansⅣ型股骨转子间骨折近期疗效较好。Objective:To compare the efficacy of Wagner-type(biotype)prosthesis replacement and internal fixation in the treatment of intertrochanteric fracture(Evans typeⅣ).Methods:74 patients with intertrochanteric fracture(Evans typeⅣ)were randomly divided into observation group and control group,37 cases in each group.The observation group was treated with Wagner-type prosthesis replacement,while the control group was treated with internal fixation.The curative effect,joint function recovery and complications of the two groups were compared.Results:The operation time and postoperative ambulation time of the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference in postoperative drainage volume and intraoperative blood loss between the two groups(P>0.05).There was no significant difference in Harris score and Singh index before operation between the two groups(P>0.05).At 3 months and 6 months after surgery,the Harris score and Singh index of the two groups were significantly higher than those before operation(P<0.05),and the Harris score of the observation group was significantly higher than that of the control group(P<0.05),but there was no significant difference in Singh index between the two groups(P>0.05).There was no significant difference in the incidence of complications between the observation group and the control group(P>0.05).Conclusion:Compared with internal fixation,Wagner-type(biotype)prosthesis replacement has better short-term effect in the treatment of unstable Evans typeⅣintertrochanteric fracture.

关 键 词：生物型假体 股骨转子间骨折 关节功能 并发症 

分 类 号：R687.3[医药卫生—骨科学]