老年高龄患者股骨转子间骨折应用PFN内固定手术与人工股骨头置换的临床分析

目的：探讨分析PFN内固定手术与人工股骨头置换术治疗老年高龄患者股骨转子间骨折的临床应用及价值。方法：选取本院2010年3月-2013年3月收治的58例股骨转子间骨折老年高龄患者，随机分为观察组与参考组各29例，给予参考组患者PFN内固定手术治疗，观察组患者行人工股骨头置换术，观察患者的术中出血量、手术时间、术后并发症发生率及完全负重时间，比较两组患者治疗3个月、1年后的Harris评分。结果：参考组患者手术时间及术中出血量及明显少于观察组组（P〈0．05），参考组患者术后并发症发生率明显少于观察组（P〈0．05）；观察组患者完全负重时间明显少于参考组（P〈0．05）；治疗3个月后，观察组患者Harris评分与参考组比较差异有统计学意义（P〈0．05）。治疗1年后，两组患者Harris评分差异无统计学意义。结论：相较人工股骨头置换，PFN内固定手术时间短且术中出血量少，术后并发症发生率明显较低，然而早期功能康复效果与人工股骨头置换有一定的差距，两种手术方式远期治疗效果差异无统计学意义。

Clinical Analysis on Applying PFN Internal Fixation Operation and Artificial Femoral Head Replacement to the Elderly Patients with Femoral Intertrochanteric Fracture

Objective： To investigate and analyze the PFN internal fixation operation and artificial femoral head replacement treatment of femoral intertrochantefic fracture in elderly patients with the clinical application and value. Method： 58 eases with femur rotor in our hospital from 2010 March to 2013 March were fracture between elderly patients, randomly divided into observation group and reference group, 29 cases in each group. To give the reference fixed operation in patients with PFN, and patients in the observation group underwent artificial femoral head replacement. Full weight beating time, complication rate, and amount the operation time, bleeding, postoperative observation of patients were compared between the two groups 3 months, 1 years after the Harris score. Result： The operation time, bleeding volume, and reference complications of the reference group was less than that of the observation group （ P〈0.05 ） . The full weight bearing time of the observation group was significantly less than that of the reference group （ P〈0.05 ） . After 3 months of treatment, the observation group was significantly better than reference group （ P〈0.05 ）, with statistical significance. After 1 years of treatment, there was no significant difference between the two groups, the Harris score had no statistical significance. Conclusion： Compared with artificial femoral head replacement, the PFN operation time shorter fixation and less blood loss in operation, and the postoperative complication rate is significantly lower, but the early rehabilitation effect of PFN internal fixation and hemiarthroplasty have a certain gap, two kinds of operation way forward no significant differences in treatment effects.