人工股骨头置换术治疗高龄股骨粗隆间骨折疗效的临床研究

目的:探讨人工股骨头置换术治疗高龄股骨粗隆间骨折的临床疗效及意义。方法:对我院2005年1月至2010年1月收治的101例高龄股骨粗隆间骨折患者的临床资料进行回顾性分析,观察人工股骨头置换术及动力性髓螺钉(DHS)内固定术治疗的临床疗效,并进行统计分析。结果:股骨头置换组手术时间、术中出血量多于DHS组,组间比较有显著差异(P<0.05);下地负重时间较DHS组明显提前,组间比较有显著差异(P<0.01);股骨头置换组的近期疗效较好,其术后1个月髋关节Harris评分明显高于DHS组,组间比较有显著差异(P<0.05),但远期疗效相当(术后6个月、24个月髋关节Harris评分无显著差异)。股骨头置换组的近期并发症发生率为10.5%,明显低于DHS组的35.0%,组间比较有显著差异(P<0.05)。结论:人工股骨头置换术治疗高龄股骨粗隆间骨折具有近期疗效好,关节功能恢复快,下地负重时间短,并发症少等优点,是目前治疗高龄股骨粗隆间骨折的一种较佳方案。

The Clinical Study of Therapeutic Effect of Artificial Femoral HeadReplacement in the Treatment of Old Patients with IntertrochantericFemoral Fracture

Objective: To investigate the clinical effect and significance of artificial femoral head replacement to intertrochanteric femoral fractures.Method: The retrospective analysis was used to analyze the clinical data of 101 old patients with intertrochanteric femoral fracture treated in our hospital from Jan.2005 to Jan.2010 and to obseve the clinical efficacy of artificial femoral head replacement and dynamic medullary screw(DHS) fixation,at last to do the statistical analysis.Result: The operation time,blood loss was significantly longer(and more) in the femoral head replacement group than that in the DHS group,which had significant difference(P <0.05);The weight loading time on the floor of the femoral head replacement group was significantly earlier than that of the DHS group,which had statistical difference among two groups(P<0.01);The short-term effect of the femoral head replacement group was better than that of the DHS group,the harris hip scores of the femoral head replacement group were significantly higher than those of the DHS group,which had significant difference(P<0.05),but they had almost the same long-term effect(harris hip scores were of no significant difference after 6 months and 24 months).Hemiarthroplasty group’s recent complication rate was 10.5%,which was significantly lower than DHS group(35.0%),there was significant difference between the two groups(P<0.05).Conclusion: The artificial femoral head replacement therapy has good short-term curative effect,with rapid recovery of joint function short weight loading time and fewer complications,which is a better method to treat intertrochanteric fracture.