长柄人工双动股骨头置换、DHS及PFN治疗高龄患者股骨粗隆间骨折的对比研究

目的对比研究三种不同的代表性方法治疗高龄患者粉碎性粗隆间骨折的手术创伤大小及术后疗效差异。方法选取应用DHS、PFN及长柄人工股骨头置换进行治疗的71例高龄粉碎性粗隆间骨折患者作为研究对象,分为A组（DHS组）、B组（PFN组）和C组（长柄人工双动股骨头置换组）。观察指标包括手术时间、术中失血量、术后并发症等临床指标及术后Harris评分。结果①在手术、住院和卧床时间方面,C组与A、B两组间比较差异有统计学意义（P〈0.05）,在出血量方面三组比较差异无统计学意义（P〉0.05）。②术后功能C组与A、B两组间、A组与B组间比较差异均有统计学意义（P〈0.05）。③A、B、C三组术后并发症发生率分别为31.0%、23.8%、21.1%,A、B两组分别有2例和1例行二次手术。结论长柄双动股骨头置换手术创伤小,疗效高,并发症少,是一种理想的选择。

Comparative study of long stem bipolar hemiarthroplasty,DHS and PFN in the treatment of elderly patients with comminuted intertrochanteric fracture

Objective To compare the curative effect and surgical trauma of three different surgical methods in treatment of comminuted intertrochanteric fracture aged patients.Methods Seventy-one cases with comminuted intertrochanteric fracture were performed with dynamic hip screw（DHS） or proximal femoral nail or（PFN） long stem bipolar hemiarthroplasty.These cases were divided into group A,group B and group C according to the surgical methods.The followed-up content include operation time,blood losing,the complication after operation and the score of Harris.Results ①After statistical analysis,there was significant difference in operation time,the time of lying in bed between group C and group A,B.But there was no significant difference in blood loss.②In the excellent and good rate of postoperation function,there was significant difference between group C and group A,B,meanwhile,there was significant difference between group A and group B.③The rate of complication after operation in group A,B and C was 31.0%,23.8% and 21.1% respectively,and there were 2 cases and 1 case who had to underwent the second operation in group A and B respectivelys.Conclusion The long stem bipolar hemiarthroplasty is an ideal method because of its small surgical trauma,good curative effect and few complication.