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人工股骨头置换与动力髋螺钉治疗老年股骨颈基底部骨折并骨质疏松的疗效比较
引用本文:覃文杰,尹东,黄宇,莫冰峰.人工股骨头置换与动力髋螺钉治疗老年股骨颈基底部骨折并骨质疏松的疗效比较[J].骨科,2015,6(3):140-144.
作者姓名:覃文杰  尹东  黄宇  莫冰峰
作者单位:广西壮族自治区人民医院骨科, 南宁,530021
摘    要:目的 分析人工股骨头置换术(artificial femoral head replacement,AFHR)与动力髋螺钉(dynamic hip screw,DHS)内固定在治疗老年股骨颈基底部骨折并骨质疏松患者中的应用,对比两者在疗效上的差异.方法 回顾性分析我科2008年6月至2014年6月期间收治的47例老年骨质疏松股骨颈基底部骨折患者,按照手术方式进行分组:AFHR组22例,DHS组25例.详细记录并比较两组患者术中的出血量、术后引流量、手术时间、手术前后血红蛋白量以及术后第6、12个月髋关节功能的Harris 评分.根据骨盆平片及患髋侧位X线片观察股骨假体及钢板周围骨质的变化情况.结果 AFHR组的术中出血量、术后引流量、手术时间、手术前后血红蛋白量以及术后髋关节功能Harris评分优于DHS组,差异有统计学意义(P<0.05).结论 对于合并有骨质疏松的股骨颈基底部骨折的老年患者,AFHR手术时间短、出血少、近期髋关节功能恢复良好,临床效果较DHS更具优势.

关 键 词:股骨颈骨折  骨质疏松  关节成形术  置换  骨折固定术    老年人
收稿时间:2014/11/13 0:00:00
修稿时间:2015/3/6 0:00:00

Curative effectiveness of artificial femoral head replacement vs. dynamic hip screw for femoral neck basal fracture in elderly patients with osteoporosis
QIN Wenjie,YIN Dong,HUANG Yu and Mo Bingfeng.Curative effectiveness of artificial femoral head replacement vs. dynamic hip screw for femoral neck basal fracture in elderly patients with osteoporosis[J].Orthopaedics,2015,6(3):140-144.
Authors:QIN Wenjie  YIN Dong  HUANG Yu and Mo Bingfeng
Institution:Department of Orthopaedics, Guangxi Zhuang Autonomous Region People''s Hospital, Nangning 530021, China,Department of Orthopaedics, Guangxi Zhuang Autonomous Region People''s Hospital, Nangning 530021, China,Department of Orthopaedics, Guangxi Zhuang Autonomous Region People''s Hospital, Nangning 530021, China and Department of Orthopaedics, Guangxi Zhuang Autonomous Region People''s Hospital, Nangning 530021, China
Abstract:Objective]To retrospectively analyze the effect of hemiarthroplasty and dynamic hip internal fixation screw on the basal parts of the femoral neck fracture for elderly patients with osteoporosis,and to compare the differences on clinical effect.Method]From June 2008 to June 2014, elderly patients of osteoporotic basal parts of the femoral neck fracture were divided into two groups: hemiarthroplasty group (22 cases) ,DHS group (25 cases) ; Detailed records of two groups of Intraoperative bleeding and postoperative flow volume ,operation time , the amount of hemoglobin before and after operation ,Harris hip joint function score of postoperative 6 and 12 months .To observe bone change arround the femoral prosthesis and steel plate According to the pelvic plain radiographs and lateral hip X-ray .Result] Intraoperative bleeding and postoperative flow volume ,operation time , the amount of hemoglobin before and after operation showed significant difference between two groups (p<0.05) .Conclusion]In the treatment of elderly patients of osteoporotic basal parts of the femoral neck fracture, hemiarthroplasty can improve the hip joint function in the short time which has the advantages of short time operation and less bleeding, and the clinical effect is better than dynamic hip screw.
Keywords:Femoral neck fractures  Osteoporosis  Arthroplasty  replacement  Fracture fixations  internal  Aged
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