2种内固定方式在高龄股骨转子间骨折行人工股骨头置换术中的临床应用分析  

Clinical application analysis of two internal fixation methods in artificial femoral head replacement for intertrochanteric fractures in the elderly

作　　者：高林 王明友 杨晓琴 王洪平 兰玉平[1] GAO Lin;WANG Mingyou;YANG Xiaoqin;WANG Hongping;LAN Yuping(Department of Orthopaedics,Panzhihua Central Hospital,Panzhihua,Sichuan 617000,China;Department of Hepatology,Panzhihua Central Hospital,Panzhihua,Sichuan 617000,China)

机构地区：[1]攀枝花市中心医院骨科,四川攀枝花617000 [2]攀枝花市中心医院肝胆科,四川攀枝花617000

出　　处：《现代医药卫生》2024年第14期2380-2384,共5页Journal of Modern Medicine & Health

基　　金：2019年度四川省攀枝花市指导性科技计划项目(2019ZD-S-1)。

摘　　要：目的评价2种不同内固定方式在高龄股骨转子间骨折行人工股骨头置换术中的临床应用效果。方法回顾性分析2017年12月至2020年12月该院骨科收治的高龄股骨转子间骨折行人工股骨头置换术患者100例,根据采用普通钢丝或大粗隆钢板内固定分为观察组及对照组,观察组患者78例采用普通钢丝捆扎固定,而对照组患者22例采用大粗隆钢板固定。记录2组患者手术时间、术中出血量、住院费用、住院时间、术后并发症、采用髋关节视觉模拟评分法(VAS)评分及Harris评分评估2组患者临床疗效。结果患者获6~18个月随访,平均(10.89±4.29)个月,至末次随访时患者已死亡13例,其中对照组4例,观察组9例。所有患者均顺利完成手术,2组患者Tronzo-Evans分型比较,差异有统计学意义(P<0.05);其余一般资料比较,差异无统计学意义(P>0.05);2组患者住院时间、术中出血量、末次随访时髋关节VAS评分及Harris评分比较,差异均无统计学意义(P>0.05);观察组手术时间较对照组短,住院费用较对照组低,差异均有统计学意义(P<0.05);观察组术后并发症发生率较对照组低,差异有统计学意义(P<0.05)。结论虽然普通钢丝捆扎固定在手术时间、住院费用及术后并发症方面较大粗隆钢板固定更有优势,但大粗隆钢板的应用能简化手术操作且术中固定更牢靠,尤其适用于复杂股骨转子间骨折患者。而在2种方式的选择上,需根据患者的骨折程度及实际情况而定,目前并无统一的标准。Objective To evaluate the clinical effect of two different internal fixation methods in elderly patients in artificial femoral head replacement for intertrochanteric fracture in elderly patients.Methods A total of 100 elderly patients with intertrochanteric fractures who underwent artificial femoral head replacement in the Department of Orthopaedics,this hospital from December 2017 to December 2020 were retrospectively analyzed.They were divided into observation group and control group according to the use of ordinary steel wire or greater trochanter plate internal fixation.78 patients in the observation group were fixed with ordinary steel wire,while 22 patients in the control group were fixed with greater trochanter plate.The operation time,intraoperative blood loss,hospitalization expenses,hospitalization time,postoperative complications,hip joint visual analogue scale(VAS)score and Harris score were used to evaluate the clinical efficacy of the two groups.Results The patients were followed up for 6-18 months,with an average of(10.89±4.29)months.By the last follow-up,13 patients had died,including four in the control group and nine in the observation group.All patients successfully completed the operation,and the difference of Tronzo-Evans classification between the two groups was statistically significant(P<0.05).There was no significant difference in other general data(P>0.05).There were no significant differences in hospitalization time,intraoperative blood loss,hip VAS score and Harris score at the last follow-up between the two groups(P>0.05).The operation time of the observation group was shorter than that of the control group,and the hospitalization cost was lower than that of the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Although the ordinary steel wire binding fixation has more advantages than the troc

关 键 词：高龄 股骨转子间骨折 人工关节置换 钢丝 大粗隆钢板 

分 类 号：R816.8[医药卫生—放射医学]