老年严重骨质疏松性股骨粗隆间骨折两种内固定术的临床观察

目的:通过对DHS(Dynamic hip serew)(对照组)与DHS加拉力螺钉(治疗组)治疗老年严重骨质疏松性股骨粗隆间骨折的对比和分析,评价2组治疗的临床应用价值。方法:随机分为对照组35例,治疗组33例,从骨密度、术中情况、术后并发症、术后髋关节功能活动及术后疗效方面,对2组治疗方法进行分析比较。结果:68例患者获8～26个月(平均18个月)随访,2组在手术时间、出血量方面比较差异无统计学意义,但在骨性愈合时间、术后并发症、术后Harris髋关节功能评分、术后疗效方面治疗组明显优于对照组。结论:治疗组与对照组都是目前治疗老年严重骨质疏松性股骨粗隆间骨折较理想的髓外内固定方式,但是治疗组比对照组临床疗效更优。

The Clinical Trail of Two Internal Fixations in Treating Severe Senile Osteoporotic Intertrochanter Fracture of Femur

Objective：To evaluate the clinical value of two kinds of internal fixations by comparing and analyzing the treatment of severe senile osteoporotic intertrochanter fracture of femur. Methods：Sixty-eight cases were randomly divided into two groups,35 cases in the control group treated with DHS （dynamic hip screw）,and 33 cases in the treatment group treated with DHS-tensioning screw. The following aspects were observed and compared：bone density,intra-operative conditions,post-operative complications,post-operative hip joint functional activity and post-operative efficacy. Results：All the 68 patients were followed up from 8 to 26 months （averagely 18 months）.There were no significant differences in the operating time and blood loss between the two groups. While in bone healing time,the post-operative complications,post-operative Harris hip function scores and post-operative efficacy,the results were better in the treatment group than in the control group. Conclusion：The two methods were the ideal extramedullary internal fixation methods for the treatment of severe senile osteoporotic intertrochanter fracture of femur at present. But the treatment group is prior to the control group in clinical efficacy.