单纯钢丝环扎固定联合股骨头置换术治疗老年骨质疏松性股骨粗隆间骨折的效果观察  

Effects of simple wire cerclage fixation combined with femoral head replacement in the treatment of elderly osteoporotic femoral intertrochanteric fractures

作　　者：文政[1] 刘明勋[1] 周莹 龚春柱[1] 孙勇[1] Wen Zheng;Liu Ming-xun;Zhou Ying;Gong Chun-zhu;Sun Yong(Department of Geriatric Orthopedics,Shenzhen Pingle Orthopedics Hospital,Shenzhen 518000,China)

机构地区：[1]深圳平乐骨伤科医院老年骨科,深圳518000

出　　处：《湖南师范大学学报（医学版）》2022年第4期39-42,共4页Journal of Hunan Normal University(Medical Sciences)

基　　金：2019年深圳市坪山区卫生系统科研项目(201924)。

摘　　要：目的:观察单纯钢丝环扎固定联合股骨头置换术治疗老年骨质疏松性股骨粗隆间骨折的临床价值。方法:选取2017年1月~2021年6月本院收治的80例老年骨质疏松性股骨粗隆间骨折患者,以投掷法随机分为观察组(n=41)与对照组(n=39),观察组运用单纯钢丝环扎固定联合股骨头置换术治疗,对照组运用钢针张力带固定加股骨头置换术治疗。两组患者均采用髋关节后外侧入路。比较2组Harris髋关节评分、手术优良率、手术时间、术中出血量、手术切口、开始下地时间、骨折愈合时间、完全负重时间、术后并发症发生情况。结果:观察组患者术后3个月及6个月关节疼痛评分、Harris髋关节评分高于对照组;观察组治疗优良率明显高于对照组;观察组骨折愈合时间少于对照组,两组其他围手术期指标无统计学差异;观察组患者术后下地时间、骨折愈合时间及完全负重时间均短于对照组;对照组主要并发症为大粗隆骨折快移位、骨折不愈合,观察组并发症发生率明显低于对照组。结论:单纯钢丝环扎固定联合股骨头置换术治疗老年骨质疏松性股骨粗隆间骨折提高了治疗优良率,缩短了骨折愈合及完全负重时间,术后并发症少。Objective To observe the clinical value of simple wire cerclage fixation combined with artificial femoral head replacement in the treatment of elderly osteoporotic femoral intertrochanteric fractures.Methods 80 elderly patients with osteoporotic femoral intertrochanteric fractures treated in the hospital were selected between January 2017 and June 2021 and were randomly divided into observation group (n=41) and control group (n=39) by throwing method.The observation group was treated with simple wire cerclage fixation combined with femoral head replacement,and the control group was given steel needle tension band fixation and femoral head replacement.Both groups adopted posterolateral hip approach.The Harris hip score,excellent and good rate of surgery,surgical time,intraoperative blood loss,surgical incision,ambulation time,fracture healing time,complete weight bearing time and occurrence of postoperative complications were compared between the two groups.Results The joint pain score and Harris hip score in observation group were higher than those in control group at 3 months and 6 months after surgery.The excellent and good rate of treatment of 85.37% in observation group was significantly higher than 61.54% in control group.The fracture healing time was shorter in observation group than that in control group,and there were no statistical differences in other perioperative indicators between the two groups.The postoperative ambulation time,fracture healing time and complete weight bearing time in observation group were shorter than those in control group.The main complications in control group were rapid displacement of greater trochanter fracture and nonunion of fracture,and the incidence rates of complications of observation group were significantly lower than those of control group.Conclusion Simple wire cerclage fixation combined with femoral head replacement for the treatment of elderly osteoporotic femoral intertrochanteric fractures improves the excellent and good rate of treatment,shortens the fracture

关 键 词：老年骨质疏松性股骨粗隆间骨折 钢丝环扎固定 人工全髋关节置换术 疗效 

分 类 号：R683.4[医药卫生—骨科学]