解剖型钢板与髋动力螺钉治疗老年人股骨粗隆间骨折的疗效比较

目的 比较解剖型钢板与髋动力螺钉治疗老年人股骨粗隆间骨折的疗效.方法 回顾性分析解剖型钢板（观察组,36例）和髋动力螺钉（对照组,34例）治疗老年人股骨粗隆间骨折的临床资料.结果 观察组手术时间、术中出血量、术后住院时间和骨折愈合时间均明显小于对照组（t=2.18、2.35、2.31、2.15,均P ＜0.05）.观察组术后发生并发症3例,其中肺部感染2例、髋关节内翻畸形1例；对照组术后发生并发症9例,其中肺部感染2例、髋关节内翻畸形4例、下肢短缩畸形2例和下肢深静脉血栓1例.观察组术后并发症发生率（8.33％）明显少于对照组（26.47％）（x2=4.05,P＜0.05）.术后随访12 ～21个月,平均（16.7＆#177;4.2）个月,观察组术后髋关节功能优良率（86.11％）明显优于对照组（64.71％）（x2=4.36,P ＜0.05）.结论 解剖型钢板和髋动力螺钉治疗老年人股骨粗隆间骨折均具有较好的疗效,前者具有手术时间短、术中出血量少、术后住院时间、骨折愈合快、术后并发症少和术后髋关节功能优良率高等优点,尤其适合髋动力螺钉无法治疗性的粉碎性骨折.

Comparison of the effect of anatomical plate and dynamic hip screw for elderly patients with intertrochanteric fracture

Objective To compare the effect of anatomical plate and dynamic hip screw（DHS） for elderly patients with intertrochanteric fracture.Methods The clinical data of medical treatments for elderly patients with intertrochanteric fracture were retrospectively analyzed.36 cases received anatomical plate treatment were selected as observation group,and 34 cases received DHS were selected as control group.Results The operation time,intraoperative blood loss,postoperative length of stay（LOS） and the time of fracture healing in observation group were obviously shorter than those in control group（t =2.18,2.35,2.31,2.15,all P 〈0.05）.In observation group,3 cases appeared postoperative complications,included 2 cases of pulmonary infection,and 1 case of varus deformity of hip joint.In control group,9 cases appeared postoperative complications,included 2 cases of pulmonary infection,4 cases of varus deformity of hip joint,2 cases of limb shortening deformity,and 1 case of deep venous thrombosis of lower extremity.The incidence rate of complication of the observation group was 8.33%,which was significantly lower than 26.47% of the control group （x2 =4.05,P 〈 0.05）.The patients were followed up for 12 to 21 months after operation,average （16.7 ＆#177;4.2）months,the excellent and good rate of the function of postoperative hip joint in the observation group was 86.11%,which was significantly higher than 64.71% in the control group （x2 =4.36,P 〈 0.05）.Conclusion Both anatomical plate and DHS have favorable effect on old patients with intertrochanteric fracture,and anatomical plate has advantages such as short operation time,a small amount of intraoperative bleeding,short postoperative LOS,short time of fracture healing,less postoperative complication,high excellent and good rate of the function of postoperative hip joint and etc,and it is preferably suitable for the comminuted fracture which cannot be cured by DHS.