人工股骨头置换与动力髋螺钉内固定治疗股骨粗隆间骨折的效果比较

目的 通过对使用人工股骨头置换与动力髋螺钉(DHs)内固定治疗股骨粗隆间骨折的结果进行比较分析,探讨两者之间的差别.方法 86例高龄股骨粗隆间骨折患者,分别采用人工股骨头置换(半髋组)及DHS内固定方法(DHS组)治疗,经过6个月以上的随访,比较两组患者在手术时间、术中出血、术后并发症、累积生存情况、术后髋部功能评分及丢失情况等方面存在的差异.结果 两组患者在手术时间、术中出血、术后全身并发症等方面无明显差异.局部症状,DHS组出现了内固定穿出骨皮质以及内侧皮质塌陷所造成的髋内翻现象,而半髋组患者则出现髋部及大腿疼痛;DHS组髋关节综合评分下降9.5%,半髋组则下降9.2%.结论 对于高龄、骨质疏松及骨折粉碎等不稳定类型的股骨粗隆间骨折患者,人工股骨头置换术是粗隆间骨折内固定术较为合理的替代术式.

Comparison of hip arthroplasty and internal fixation for the treatment of intertrochanteric fractures

Objective To compare the effect of hip artificial replacement and DHS internal fixation for the treatment of intertrochanteric fracture, and investigate the difference of the two method. Methods Eighty-six pa- tients with intertrochanterie fracture patients were treated with hip arthroplasty, and dynamic hip screw. The pa- tients were followed up for 6 months, and compared the operation rime, blood loss, postoperative complications, sur- vival rate, postoperative hip function score and lose situation. Results There was no significant difference in opera- tion time,blood loss,postoperative complications,in local symptoms hip varus deformation occured in the DHS inter- hal fixation because lag screw cut-our and the collapse of the medial cortex, hip and thigh pain oecured in artificial re- placement,hip function score dropped 9.5 % in DHS and 9.2% in artificial replacement. Conclusion For elderly patients, eomminuted fracture and osteoporosis, and other types of unstable intertrochanteric fracture patients, the primary purpose of surgery is to provide to patients more activities of the early conditions,so hip arthroplasty can be used to the treatment of intertrochanteric fracture,as a reasonable replacement surgery.