动力髋联合骨水泥与人工股骨头置换治疗高龄不稳定性转子间骨折疗效分析

发布时间：2018-08-16 11:12

【摘要】：目的探讨动力髋(Dynamic hip screws,DHS)联合骨水泥和人工股骨头置换(Artificial femoral head replacement)治疗高龄伴有严重骨质疏松的不稳定性转子间骨折的临床疗效。方法选择2010年1月-2012年12月40例75岁以上高龄不稳定型转子间骨折患者,分为动力髋内固定组和人工股骨头置换组,每组各20例,对两组患者的术中出血量、术后输血量、住院时间、卧床时间及并发症发生情况等进行比较,并根据髋关节功能情况,对动力髋内固定组和人工股骨头置换组Harris评分进行比较。结果所有患者均得到随访,随访时间12~48个月,平均22个月。两组患者手术时间、术中出血量、术后输血量及住院时间差异无统计学意义(P0.05)。人工股骨头置换组术后卧床时间短于动力髋内固定组,差异有统计学意义(P0.05)。动力髋内固定组并发2例髋内翻,优良率为90.0%。人工股骨头置换组并发1例髋内翻,优良率为95.0%。动力髋内固定组Harris评分(91.8±6.1)分,人工股骨头置换组(92.5±5.6)分,两组差异无统计学意义(P0.05)。结论动力髋内固定手术和人工股骨头置换手术对高龄不稳定性转子间骨折治疗各具优势,只要掌握好适应证,可以达到较好的效果。
[Abstract]:Objective to investigate the clinical efficacy of dynamic hip (Dynamic hip screwsDHS combined with bone cement and artificial femoral head replacement (Artificial femoral head replacement) in the treatment of unstable intertrochanteric fractures in elderly patients with severe osteoporosis. Methods from January 2010 to December 2012, 40 patients with unstable intertrochanteric fracture over 75 years old were divided into two groups: dynamic hip fixation group and artificial femoral head replacement group. The Harris scores of dynamic hip fixation group and artificial femoral head replacement group were compared according to the hip joint function. Results all patients were followed up for 12 ~ 48 months (mean 22 months). There was no significant difference in operation time, blood loss, blood transfusion and hospital stay between the two groups (P0.05). The time of bed rest in artificial femoral head replacement group was shorter than that in dynamic hip fixation group, the difference was statistically significant (P0.05). There were 2 cases of coxa varus in dynamic hip fixation group, the excellent and good rate was 90.0%. In the artificial femoral head replacement group, 1 case had coxa varus, the excellent and good rate was 95.0%. The Harris score was (91.8 卤6.1) in the dynamic hip fixation group and (92.5 卤5.6) in the artificial femoral head replacement group. There was no significant difference between the two groups (P0.05). Conclusion dynamic hip internal fixation and artificial femoral head replacement have respective advantages in the treatment of unstable intertrochanteric fractures in elderly patients.
【作者单位】：新疆医科大学第一附属医院关节外科;
【基金】：卫生部公益性行业科研专项项目(201302007)
【分类号】：R687.3

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