半髋关节置换、防旋型股骨近端髓内钉治疗高龄不稳定型股骨转子间骨折的效果比较

目的探讨高龄不稳定型股骨转子间骨折实施半髋关节置换、防旋型股骨近端髓内钉临床治疗效果比较。方法随机选取本院2015年3月～2016年1月收治的105例高龄不稳定型股骨转子间骨折患者进行回顾性研究,按入院治疗方式不同分为观察组53例、对照组52例,对照组予半髋关节置换手术,观察组予防旋型股骨近端髓内钉治疗,对两组手术情况、固定术后Harris评分、不良反应进行比较。结果两组患者术后1、3、9个月Harris评分比较中观察组术后1个月评分低于对照组,两组差异有统计学意义(P0.05),术后3、9个月两组评分比较差异无统计学意义(P0.05),观察组切口长度、手术时间、出血量优于对照组,两组比较差异有统计学意义(P0.05),两组住院时间比较差异无统计学意义(P0.05),观察组并发症发生率为11.3%,对照组为3.8%,两组差异有统计学意义(P0.05)。结论临床上针对高龄不稳定型股骨转子间骨折,应当根据患者实际情况,选择半髋关节置换、防旋型股骨近端髓内钉治疗,最终促进患者术后康复。

Hemi -hip replacement and anti -rotation proximal femoral intrame -dullary nail for treatment of unstable intertrochanteric fractures in elderly patients

Objective To compare the clinical effects of hemi-hip replacement and anti-rotation proximal femoral intramedullary nail in the treatment of unstable intertrochanteric fractures in elderly patients. Methods 105 elderly patients with unstable intertrochanteric fractures who were admitted in our hospital from March 2015 to January 2016 were randomly selected and retrospectively studied. According to the hospital admission treatment methods, the patients were divided into observation group(n=53) and control group(n=52). The control group received hemi-hip replacement.The observation group was treated with anti-rotation proximal femoral intramedullary nail. The surgical conditions, Harris score after fixation and adverse reactions were compared between the two groups. Results In the comparison of Harris score between the two groups at 1, 3, and 9 months after surgery, Harris score in the observation group at the 1st month after surgery was lower than that of the control group. There was a statistically significant difference between the two groups (P<0.05), there was no significant difference in scores between the two groups at 3 and 9 months after surgery (P>0.05). The incision length, operation time, and bleeding volume in the observation group were better than those in the control group. There was a statistically significant difference between the two groups(P<0.05). There was no statistically significant difference in the hospitalization time between two groups (P>0.05). The incidence of complications was 11.3% in the observation group and 3.8% in the control group. There was a statistically significant difference between the two groups (P<0.05). Conclusion For unstable intertrochanteric fractures in the elderly clinically, the hemi-hip replacement and anti-rotation proximal femoral intramedullary nail should be selected according to the actual conditions of the patients, to promote the patients'' postoperative recovery finally.