髋关节置换与动力髋螺钉内固定治疗超高龄股骨粗隆间骨折的疗效对比

目的比较髋关节置换与动力髓螺钉（Dynamic hip screw,DHS）内固定两种不同方法治疗超高龄股骨粗隆间骨折的疗效。方法对本院2006年10月至2010年10月间行手术治疗的128例超高龄股骨粗隆间骨折患者的临床资料进行回顾性分析。结果 DHS内固定组与髋关节置换组在手术时间上相比差异无统计学意义,但是DHS内固定组术中出血量、术后卧床时间、住院时间、术后并发症发生率、功能恢复时间都明显大于髋关节置换组,而术后Harris评分DHS内固定组明显优于髋关节置换组。结论对于身体素质较好的超高龄患者首选DHS内固定治疗股骨粗隆间骨折,对于身体素质较差的超高龄患者应考虑髋关节置换治疗股骨粗隆间骨折。

Comparison of hip replacement with dynamic hip screw internal fixation for the treatment of the intertrochanteric fracture in the very elderly patients

Objective To compare the curative effect of hip replacement withdynamic hip screw(DHS) internal fixation for the treatment of intertrochanteric fracture in the very elderly patients.Methods The clinical data of surgical treatment of 128 very elderly patients with intertrochanteric fracture from October 2006 to October 2010 were analyzed retrospectively.Methods The clinical data of surgical treatment of 128 very elderly patients with intertrochanteric fracture from October 2006 to October 2010 were analyzed retrospectively.Results There was no significant difference between operation time in DHS internal fixation group and that in hip replacement group.However,the peri-operative bleeding,postoperative bed time,length of hospital stay,incidence rate of postoperative complications and functional recovery time in DHS internal fixation group were significantly higher those in hip replacement group,in addition,Harris Score of DHS internal fixation group had obviously an advantage to that of hip replacement group after operation.Conclusion HS internal fixation preferred to the very elderly patients in good physical condiction,whereas that in bad physical condition should consider hip replacement for the treatment of intertrochanteric fracture.