4种手术方式治疗老年不稳定型股骨转子间骨折的对比研究

发布时间：2019-06-08 08:29

【摘要】：目的：比较股骨近端解剖型锁定钢板(proximal femoral anatomic locking plate, ALP)、经皮加压钢板(percutaneous compression plate,PCCP)、全髋关节置换术(total hip arthroplasty, THA)和双极半髋关节置换术(bipolar hemiarthroplasty, BHA)治疗老年不稳定型股骨转子间骨折的疗效。方法：回顾性分析2011年12月至2013年12月重庆医科大学附属第二医院骨科采用ALP、PCCP、THA及BHA手术治疗的老年不稳定型股骨转子间骨折病例68例,男27例,女41例,年龄67岁～98岁,平均79.65岁,其中ALP组12例,PCCP组12例,THA组17例,BHA组27例。对比分析各组的手术操作时间、术中出血量、术中透视次数、术后卧床时间,以及末次随访的Harris评分。结果：手术操作时间：BHA组PCCP组THA组ALP组。术中出血量：PCCP组BHA组THA组ALP组。术中透视次数：BHA组=THA组PCCP组ALP组。术后卧床时间：THA组BHA组PCCP组ALP组。以上结果中,除THA组与BHA组的术中出血量之间无显著性差异,其余比较均有显著性差异(P0.05)。4组患者的术后髋关节功能优良率无显著性差异(P0.05)。结论：4种手术方式治疗老年不稳定型股骨转子间骨折均有较好疗效,其中BHA及PCCP的手术创伤较小,而THA及BHA在术中辐射剂量、术后康复速度方面有优势。
[Abstract]:Objective: to compare the anatomic locking plate (proximal femoral anatomic locking plate, ALP), (percutaneous compression plate,PCCP), total hip arthroplasty (total hip arthroplasty, THA) and bipolar hemi-hip arthroarthroplasty (bipolar hemiarthroplasty,). BHA) in the treatment of unstable intertrochanter fracture in the elderly. Methods: from December 2011 to December 2013, 68 elderly patients (27 males and 41 females) with unstable intertrochanter fractures were treated by ALP,PCCP,THA and BHA in the Department of Orthopaedics, the second affiliated Hospital of Chongqing Medical University. There were 12 cases in ALP group, 12 cases in PCCP group, 17 cases in THA group and 27 cases in BHA group. The operation time, intraoperative bleeding volume, intraoperative fluoroscopy times, postoperative bed rest time and Harris score of the last follow-up were compared and analyzed. Results: operation time: BHA group PCCP group THA group ALP group. Intraoperative blood loss: PCCP group BHA group THA group ALP group. Intraoperative fluoroscopy times: BHA group = THA group PCCP group ALP group. Postoperative bed rest time: THA group BHA group PCCP group ALP group. Among the above results, there was no significant difference in intraoperative blood loss between THA group and BHA group, but there was significant difference in the rest (P 0.05). There was no significant difference in the excellent and good rate of hip joint function between the four groups (P 0.05). Conclusion: the four surgical methods are effective in the treatment of unstable intertrochanteric fractures in the elderly, among which BHA and PCCP have less trauma, while THA and BHA have advantages in intraoperative radiation dose and postoperative rehabilitation speed.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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