LPFP、PFNA和BPH治疗高龄股骨粗隆间骨折的临床效果分析

发布时间：2018-04-24 23:43

  本文选题：高龄股骨粗隆间骨折 + 股骨近端锁定接骨板　； 参考：《青岛大学》2017年硕士论文

【摘要】：【目的】分析股骨近端锁定接骨板(LPFP)、股骨近端防旋髓内钉(PFNA)及双极人工股骨头置换(BPH)治疗高龄老年人股骨粗隆间骨折的临床效果。【方法】回顾性分析86例自2011年6月至2016年8月采用LPFP、PFNA内固定及BPH治疗75岁以上高龄股骨粗隆间骨折患者临床资料,各组:LPFP组男10例,女16例;PFNA组男17例,女22例;BPH组男9例,女12例。LPFP组年龄72.54±4.78岁;PFNA组年龄74.41±5.65岁;BPH组年龄76.23±6.97岁。平均病程2~3月。LPFP组中EvansⅡ型5例,Ⅲ型12例,Ⅳ型9例;PFNA组中EvansⅡ型11例,Ⅲ型18例,Ⅳ型10例;BPH组中EvansⅡ型1例,Ⅲ型10例,Ⅳ型10例。比较3组手术时间、术中出血量、住院时间、术后并发症发生率和髋关节功能Harris评分。【结果】术后患者伤口愈合良好,无并发症发生。84例获得随访,2例失访(随访率为97.6%)。术后随访42~62个月,平均46.3个月。(一)手术时间及住院时间比较中,BPH组明显比LPFP组和PFNA组明显缩短,具有统计学差异(F=19,782,21.981;P0.05);LPFP组和PFNA组2组组间比较中,LPFP组与PFNA组无统计学差异(T=-0.21,P0.05)。(二)术中出血量的比较中,BPH组比PFNA组和LPFP组明显减少,差异有统计学意义(F=12.976,P0.05);PFNA组与LPFP组2组的组间比较无显著差异(T=0.879,P0.05)。(三)术后并发症发生率的比较中,LPFP组较PFNA组和BPH组高,差异有统计学意义(F=30.976,P0.05);PFNA组与BPH组间比较无显著差异(T=0.902,P0.05)。(四)术后3周关节Harris评分的比较中,BPH组得分高于LPFP组及PFNA组,差异有统计学意义(F=32.871,P0.05);术后6个月及2年髋关节功能Harris评分的比较中,PFNA组和BPH组均优于LPFP组(F=42.871,P0.05),而PFNA组与BPH 2组组间比较无显著差异(T=4.971,P0.05)。【结论】对于全身情况较差的高龄患者(75岁),BPH手术时间短,术后并发症少,是最优的选择。对于单纯的股骨粗隆间骨折患者,PFNA也具有明显的优势,术者可根据情况选择。对于高龄的股骨粗隆间骨折患者,不建议应用LPFP。
[Abstract]:[objective] to analyze the clinical effect of LPFP, PFNAand bipolar artificial femoral head replacement in the treatment of femoral intertrochanteric fractures in elderly patients. [methods] 86 cases of femoral intertrochanteric fractures were retrospectively analyzed since 2011. [objective] to analyze the clinical effect of LPFPN, PFNAand bipolar artificial femoral head replacement in the treatment of femoral intertrochanteric fractures in the elderly. [methods] 86 cases of femoral intertrochanteric fractures were retrospectively analyzed. From June 2000 to August 2016, patients with intertrochanteric fracture of femur were treated with LPFPN PFNA and BPH. There were 10 males, 17 females in PFNA group, 9 males in BPH group and 12 females in LPFP group. The age of PFNA group was 72.54 卤4.78 years old. The age of BPH group was 76.23 卤6.97 years old. There were 5 cases of Evans type 鈪，

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