人工股骨头置换术与股骨近端防旋髓内钉内固定术治疗老年股骨粗隆间骨折患者的效果比较

目的:比较人工股骨头置换术与股骨近端防旋髓内钉内固定术治疗老年股骨粗隆间骨折患者的效果。方法:选取88例老年股骨粗隆间骨折患者作为研究对象,按随机数字表法将其分为观察组和对照组各44例。对照组行股骨近端防旋髓内钉内固定术治疗,观察组行人工股骨头置换术治疗,比较两组手术相关指标水平、手术前后髋关节功能评分、疼痛评分和并发症发生率。结果:观察组术后首次下床活动时间和术后住院时间均短于对照组,出血量多于对照组,切口长度和手术时间均长于对照组,差异有统计学意义(P<0.05);术后3个月,两组Harris髋关节功能评分均高于术前,但组间比较,差异无统计学意义(P>0.05);术后6个月,两组Harris髋关节功能评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后3 d及2周,观察组VAS评分均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为29.55%(13/44),高于对照组的9.09%(4/44),差异有统计学意义(P<0.05)。结论:人工股骨头置换术可缩短患者术后恢复时间,更好地改善髋关节功能,股骨近端防旋髓内钉内固定治疗老年股骨粗隆间骨折患者创伤小、出血量少、手术用时短、疼痛轻,临床需根据患者病情选择适宜的手术方式治疗。

Comparison of effects of artificial femoral head replacement and anti-rotation proximal femur intramedullary nail internal fixation in treatment of elderly patients with femoral intertrochanteric fractures

Objective:To compare effects of artificial femoral head replacement and anti-rotation proximal femur intramedullary nail internal fixation in treatment of elderly patients with femoral intertrochanteric fractures.Methods:88 elderly patients with femoral intertrochanteric fractures were selected as the research objects,and were divided into observation group and control group according to the random number table method,44 cases in each group.The control group was treated with anti-rotation proximal femur intramedullary nail internal fixation,while the observation group was treated with artificial femoral head replacement.The levels of surgery-related indicators,the hip joint function scores before and after the surgery,the pain score and the complication rate were compared between the two groups.Results:The first out-of-bed time and the postoperative hospitalization time of the observation group were shorter than those of the control group;the amount of bleeding was more than that of the control group;the incision length and the operation time were longer than those of the control group;and the differences were statistically significant(P<0.05).3 months after the surgery,the Harris hip scores in both groups were higher than those before the surgery;however,there was no statistically significant difference between the groups(P>0.05).6 months after the surgery,the Harris hip scores of the two groups were higher than those before the surgery;that of the observation group was higher than that of the control group;and the differences were statistically significant(P<0.05).3 days and 2 weeks after the surgery,the VAS scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 29.55%(13/44),which was higher than 9.09%(4/44)in the control group,and the difference was statistically significant(P<0.05).Conclusions:For the elderly patients with femoral intertrochanteric fractures,artificial femoral head replacement can shorten the patient’s postoperative recovery time and improve the hip joint function;while anti-rotation proximal femur intramedullary nail internal fixation can cause less traumatic,reduce the bleeding amount and the pain,and shorten the operation time.Therefore,it is necessary to choose the appropriate surgical treatment according to the patients’conditions.