两种不同方法治疗老年人股骨粗隆间骨折疗效及对髋关节功能影响比较

目的：通过比较不同内固定术在老年人股骨粗隆间骨折的临床疗效，探讨抗旋髓内钉内固定术在老年人股骨粗隆间骨折中的应用价值。方法选择160例老年股骨粗隆间骨折患者为研究对象，根据数字表法随机分为观察组（抗旋髓内钉内固定术）和对照组（动力髋螺钉内固定术）。比较两组患者治疗效果及髋关节功能恢复情况。结果观察组手术时间短于对照组，出血量少于对照组，差异均有统计学意义（t＝4.635、3．643，均P＜0．05）；观察组髋关节功能、疼痛、畸形、运动范围单项评价及总分均显著高于对照组（ t＝4．433、4．364、4．865、3．876、3．645，均P＜0．05）；观察组患者术后髋关节功能优良率为90．0％，显著高于对照组的72．5％（χ2＝5．153，P＜0．05）。结论在老年人股骨粗隆间骨折的治疗中，股骨近端抗旋髓内钉内固定术手术时间短，出血量少，术后髋关节功能恢复好，值得临床推广。

Comparison of the effect and impact on hip function of two different methods in the treatment of elderly intertrochanteric fractures

Objective To compare the effect of anti-spin intramedullary nail and dynamic hip screw fixation in the treatment of elderly intertrochanteric fractures ,in order to investigate the clinical value of anti-spin intramedul-lary nail in elderly intertrochanteric fractures .Methods 160 elderly patients with intertrochanteric fractures were divided into the observation group and control group according to the random number table .The observation group received anti-spin intramedullary nail fixation , the control group received dynamic hip screw fixation .The fracture healing and hip function of two groups were compared .Results The operative time of the observation group was shor-ter than that of the control group ,and blood loss was less than the control group ,the differences were statistically sig-nificant（t=4.635,3.643,all P〈0.05）.The function,pain,deformity,range of motion and total scores of the obser-vation group were significantly higher than those of the control group （ t=4.433,4.364,4.865,3.876,3.645,all P〈0.05）.The postoperative hip function excellent rate of the observation group was 90.0%,which was significantly higher than 72.5%of the control group （χ^2 =5.153,P〈0.05）.Conclusion Proximal femur intramedullary nail anti-rotation fixation in the treatment of elderly intertrochanteric femoral fractures has shorter operative time ,less blood loss,and postoperative hip function recovery is good ,it is worthy of promotion .