人工关节置换术及内固定术在老年不稳定型股骨转子间骨折的比较

目的分析人工关节置换术在治疗不稳定型股骨大转子间骨折的可行性及临床疗效。方法随机选取本院2009年1月-2013年9月80例手术治疗的不稳定型股骨大转子间骨折患者，分成对照组及观察组各40例，对照组采用内固定术治疗，观察组采用人工关节术治疗，分别记录患者的手术出血量、手术时间、围手术期并发症、术后下床活动的时间及术后Harris评分。结果（1）手术时间及术中出血量两者无明显差异。（2）观察组患者下床活动时间明显早于对照组（t=10．593，P=0．000）；（3）观察组围手术期并发症明显低于对照组（x^2=3．914，P〈0．05）；（4）观察组治疗有效率高于对照组（x^2=5．000，P〈0．05）。结论严格按适应证对不稳定型股骨大转子间骨折进行人工关节置换术有效，患者髋关节功能恢复良好。早期下床进行部分负重活动，预防并发症的同时可提高生活质量。

A comparison between artificial joint replacement and internal fixation in the treatment of unstable intertrochanteric fracture for elderly patients

Objective To analyze the feasibility and clinical efficacy of artificial joint replacement in the treatment of unstable intertrochanteric fracture. Methods 80 patients who received surgery of unstable intertroehanteric fracture in our hospital from January 2009 to September 2013 were randomly selectedand assigned to a control group and an observation group,with 40 in each.The control group received internal fixation,while the observation group received artificial joint replacement.Amount of bleeding during surgery,surgery time,perioperative complications,postoperative activity time and postoperative Harris scores in the patients were recorded. Results （1）There was no significant difference of surgery time and amount of bleeding in the two groups.（2）Activity time in the observation group was earlier than that in the control group（t=10.593,P=0.00）;（3）Incidence of perioperative complications in the observation group was significantly lower than that in the control group（x2 =3.914,P 〈 0.05）;（4）The effective rate in the observation group was higher than that in the control group （x2 =5.000,P 〈 0.05）. Conclusion Artificial joint replacement in the treatment of unstable intertrochanteric fracture accords with the indications and has an effective result,and the patients show a better recovery of hip joint function.Earlier activities with load helps prevent complications as well as improve life quality.