骨质疏松患者转子间骨折DHS术后的翻修治疗

目的通过人工股骨头置换翻修治疗股骨转子间骨折动力髋螺钉（DHS）术后的结果进行分析，探讨骨质疏松病人转子间骨折的治疗方法。方法采用回顾性总结的方法。收集102例高龄老人股骨转子间骨折后采用动力DHS的治疗方法，65例术后DHS内固定物松动再次行人工股骨头置换术，经过6个月以上的随访。比较不同治疗方法髋部的功能评分丢失情况等方面存在的异同。结果DHS组有63．7％内固定穿出骨皮质现象。而人工股骨头翻修患者则无明显的假体松动依据，两组患者松动率比较有显著的不同；肢体功能恢复情况，人工股骨头置换组生活质量明显好于DHS内固定组，两组有显著性差异。结论人工股骨头置换术治疗骨质疏松的转子间骨折患者，早期更多功能恢复及较少的术后松动等并发症发生。

Treatment of Hemiarthroplasty Overhauling after Dynamic Hip Screws in Osteoporosis Patients with Femoral Intertrochanteric Fractures

Objective To discuss the ways in treating osteoporosis patients with femoral intertrochanteric fractures by a comparitive analysis of the rersults of hemiarthroplaty overhauling after dynamic hip screws operation in femoral intertro-chanteric fractures. Methods With the methods of retrospective review, 102 cases of femoral intertrochanteric fractures were collected, who were treated by dynamic hip screws respectively. 65 cases received hemiarthroplaty overhauling for prosthsis loosing. Following up of more than 6 months, the loss of ambulatory grades and the rate of prosthsis loosing were compared between the two groups. Results DHS group had the cut-out from femoral head with loosening rate of 63.7%, while the hemiarthroplaty group had no evident proof of prosthesis loosening; In local symptoms, life quality of the prosthsis group were better than that of DHS treatment group with significant difference between the two groups. Conclusion To osteoporosis patients with intertrochanteric fractures, earlier fine function and less postoperative complications should be expected. The hemiarthroplaty is a reasonable alternative to treat intertrochanteric fractures.