锁定钢板和人工股骨头置换治疗老年股骨粗隆间骨折的疗效分析

目的比较锁定钢板和人工股骨头置换治疗老年人股骨粗隆间骨折的临床疗效,为临床工作提供指导。方法回顾性分析2010年1月~2013年2月收治的38例股骨粗隆间骨折患者的临床资料,年龄65~83岁,平均72岁,其中人工股骨头置换组11例,股骨近端锁定钢板组27例,从手术时间、术中出血量、卧床时间、髋关节Harris评分等方面对两种不同治疗方法进行评价。结果人工股骨头置换组手术时间短于锁定钢板组(P<0.05);但出血量多于锁定钢板组(P<0.05),锁定钢板组卧床时间长于人工股骨头置换组(P<0.05)。两组Harris评分无明显的差异(P>0.05)。结论锁定钢板和人工股骨头置换均能有效治疗老年人股骨粗隆间骨折,但应严格手术适应证,一般情况良好、骨质条件较好可选择锁定钢板治疗,而合并较重的高血压、冠心病、糖尿病等老年常见内科疾病,骨质疏松严重的患者,则应实施人工股骨头置换术。

Analysis of curative effect between locking plate and hemiarthroplasty for treatment of senile femoral intertrochanteric fracture

Objective To compare the clinical curative effect between Locking plate and artificial femoral head replacement for treatment of senile femoral intertrochanteric fracture, so as to provide guidance for clinical work. Methods Thirty-eight patients of femoral intertrochanteric fracture between January 2010 and February 2013 were analyzed retrospectively, 65-83 years old, average 72 years old, 11 cases of artificial femoral head replacement group, 27 cases of proximal femoral locking plate group, from the operation time, intraoperative blood loss, time lying in bed, Harris hip score of two different treatment methods were evaluated. Results Artificial femoral head replacement operation time shorter than locking plate group （P 〈 0.05）; but the bleeding more than locking plate group （P 〈 0.05）, the locking plate group stay in bed longer than artificial femoral head replacement group （P 〈 0.05）. Two groups of the Harris score showed no obvious difference （P 〉 0.05）. Conclusion Locking plate and artificial femoral head can be effective treatment of intertrochanteric fractures in older adults, but should strictly operation indications, generally in good condition, bone condition better locking plate treatment options are available, and merge the heavier older common medical diseases such as hypertension, coronary heart disease, diabetes, patients with severe osteoporosis, should implement the artificial femoral head replacement.