关节置换和股骨近端髓内钉治疗高龄股骨粗隆间骨折的疗效研究

发布时间：2019-01-14 12:56

【摘要】：目的探讨人工股骨头置换术和股骨近端髓内钉系统(PFNA)内固定术治疗高龄患者股骨粗隆间骨折的临床疗效。方法回顾性分析2010年12月至2014年12月我院收治的高龄股骨粗隆间骨折患者58例。比较2组患者的手术时间、术中出血量、术后引流量及关节功能评分等指标。结果人工股骨头置换组手术时间少于PFNA组;术后1个月及1年随访关节功能Harris评分优于PFNA组;关节置换组术中出血总量及术后24 h引流量明显多于PFNA组。结论 2种手术方式均可达到满意治疗效果,PFNA内固定术多适用于合并基础疾病多、术中闭合骨折复位易达到满意效果、骨质疏松程度轻、手术创伤耐受性较差等患者。对于内科相关疾病相对较轻、复位及固定困难,严重骨质疏松、手术耐受性较好患者,选择关节置换术更佳。
[Abstract]:Objective to investigate the clinical effect of artificial femoral head replacement and proximal femoral intramedullary nail system (PFNA) internal fixation in the treatment of femoral intertrochanteric fracture in elderly patients. Methods 58 elderly patients with intertrochanteric fracture of femur were retrospectively analyzed from December 2010 to December 2014. The operative time, intraoperative bleeding volume, postoperative drainage volume and joint function score were compared between the two groups. Results the operative time of artificial femoral head replacement group was less than that of PFNA group, the Harris score of joint function in 1 month and 1 year follow-up was better than that in PFNA group, and the total amount of intraoperative bleeding and 24 h drainage flow in joint replacement group were significantly more than those in PFNA group. Conclusion PFNA internal fixation is suitable for the patients with basic diseases, the reduction of closed fracture is easy to achieve satisfactory results, the degree of osteoporosis is light, and the tolerance of surgical trauma is poor. For patients with relatively mild internal diseases, difficult reduction and fixation, severe osteoporosis and better tolerance of surgery, arthroplasty is preferable.
【作者单位】：中国人民解放军第二0二医院骨科;
【基金】：辽宁省自然科学基金(2015020485)
【分类号】：R687.3

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