人工股骨头置换与内固定治疗高龄股骨粗隆间骨折结果比较

目的比较人工股骨头置换与内固定治疗高龄股骨粗隆间骨折的疗效。方法 2003～2010年在我院治疗的162例80岁以上股骨粗隆间粉碎性骨折分为两组,A组为半髋置换术,B组为内固定。随访12～78个月,平均37个月。结果按harrs评分标准。A组术后治良率达到93.8%,B组术后优良率达78.4%。髋动力带锁钢板与动力髋（DHS）固定组之间的结果没有明显差别;动力髋（DHS）术后2例出现内固定失效需行股骨头置换;内固定组中有2例因术后衰竭而死亡。结论人工股骨头置换或内固定是治疗老年股骨粗隆间骨折的有效方法,可提高老年人的生活质量,减少并发症。人工股骨头置换结果优于内固定。

Hemiarthroplasty and internal fixation of intertrochanteric fractures of elderly compare the results

Objective Comparing hemiarthroplasty and internal fixation for intertrochanteric fractures.Methods 2003～2010 in our hospital 162 cases treated over 80 years of age were divided into two groups of intertrochanteric fracture,A group of semi-hip replacement,B group fixation.Average 37-month follow-up 12～78 months.Results By harris score,A group postoperative rate is 93.8%,B group excellent rate is 78.4%.Locking plate and the dynamic hip hip power（DHS） fixation group no significant difference between the results;Dynamic hip（DHS） fixation in 2 cases after failure of femoral head replacement to be OK;internal fixation group,2 cases of the patients failure and death.Conclusion Hemiarthroplasty or internal fixation of intertrochanteric fractures of elderly patients an effective method to improve the quality of life of older people and reduce complications.Artificial femoral head replacement is better than internal fixation.