股骨头置换对高龄股骨粗隆问骨折患者术后生存质量的影响

目的探讨人工股骨头置换治疗高龄股骨粗隆间骨折的临床疗效。方法选取2008年2月～2011年10月收治的75岁以上股骨粗隆间骨折85例，其中应用人工股骨头置换术治疗39例，动力髋螺钉（DHS）内同定术治疗46例，比较两组患者开始下地负重时间、并发症发生情况、1年死亡率以及术后1、3、6、12个月时的生存质量和髋关节功能。结果置换组在术后开始下地负重时间、并发症发生率、一年死亡率、生存质量评分及早期髋关节功能评分均优于DHS组，两组比较差异有统计学意义（P〈0．05）。结论人工股骨头置换术比DHS内固定术更有利于提高患者术后生存质量，是治疗高龄股骨粗隆间骨折的一种较好的选择。

Quality of life study in elderly patients with femoral intertrochanteric fractures treated with femoral head replacement

Objective To explore the curative effects of femoral head replacement in the treatment of the elderly patients with femoral intertrochanteric fractures. Methods From February 2008 to October 2011, 85 patients over 75 years with femoral intertrochanteric fractures were chosen at random. Thirty-nine cases were treated with artificial femoral head replacement, and forty-six cases were treated with dynamic hip screw internal fixation. Comparison was made between the two treated groups in terms of beginning time of weight training out of bed after operation, complications, mortality rate in one year, quality of life and the function of hip joint in 1, 3, 6, 12 months after surgery. Resuits The clinical efficacy of artificial femoral head replacement was superior to dynamic hip screw internal fixation on beginning time of weight training out of bed after operation, complications, mortality rate in one year, quality of life score in 1, 3, 6, 12 months after surgery, the function score of hip joint in 1, 3, 6 months after surgery, and the difference between the two groups was significant （P 〈0.05）. Conclusion Artificial femoral head replacement is better than dynamic hip screw internal fixation in improving the life quality, so it can be a rational option for treatment of femoral intertrochanteric fractures in elderly patients.