2种手术方法治疗老年外侧壁非完整型股骨粗隆间骨折的早期疗效比较

目的 对比分析半髋关节置换(FHR)与股骨近端防旋髓内钉(PFNA)内固定治疗老年骨质疏松性外侧壁非完整型股骨粗隆间骨折的早期疗效.方法 选择2014年1月至2016年4月安徽医科大学第三附属医院收治的64例老年骨质疏松性外侧壁非完整型股骨粗隆间骨折患者,27例患者行半髋关节置换治疗(FHR组),37例患者行股骨近端防旋髓内钉内固定治疗(PFNA组),比较两组患者的围手术期相关指标及髋关节Harris评分.结果 64例患者均获6~12个月随访,与PFNA组相比,FHR组患者术后负重时间、住院时间短,术后2周、1个月、3个月、6个月髋关节Harris评分高,但FHR组切口长度和手术时间较PFNA组长,差异有统计学意义(P<0.05);FHR组术中出血量多于PFNA组,差异有统计学意义(P<0.05).结论 FHR治疗老年骨质疏松性外侧壁非完整型股骨粗隆间骨折早期疗效可靠,术后可更早、更快恢复髋关节功能.

Early efficacy in comparison of FHR with PFNA in treatment of elderly femoral intertrochanteric fractures with lateral wall risky and fractural

Objective To compare the early clinical efficacy of FHR and PFNA in the treatment of osteoporotic femoral intertrochanteric fractures with lateral wall risky and fractural for elderly patients. Methods From Jan.2014 to Apr.2016,the clinical data of 64 elderly osteoporotic patients diagnosed as intertrochanteric fractures were analyzed retrospectively.Among them 27 were treated with FHR and 37 were treated with PFNA. The perioperative indicators and the postoperative Harris hip score in both groups were compared. Results All of sixty-four patients were followed up for 6 to 12 months.Compared with the PFNA group, the postoperative ambulation time and hospital stay were lower in FHR group, and the Harris hip score was better in FHR group after 2 weeks,1 month, 3 months and 6 months follow-up (P<0.05).The incision length, operation time and operational blood loss in FHR group were higher than those in PFNA group (P<0.05). Conclusion FHR for the treatment of intertrochanteric fractures in the elderly patients with osteoporosis has reliable effectwith early and quick recovery of the hip joint function.