摘要
目的探讨动力髋螺钉（DHS）内固定与人工股骨头置换术治疗高龄股骨转子间骨折的方法及治疗效果。方法64例高龄不稳定股骨转子间骨折患者完全随机分为2组，DHS组34例行DHS内固定治疗，关节组30例行人工股骨头置换治疗。比较2组术后并发症及髋关节功能。结果60例获随访，时间8个月-7年，随访期内死亡5例。关节组发生并发症4例，DHS组发生13例，差异有统计学意义（P〈0．05）。患髋功能评定采用Harris评分法：关节组71～96（平均85．5±5．3）分，DHS组69～92（平均83．2±6．6）分，差异无统计学意义（P〉0．05）。结论对于年龄≥75岁，骨质疏松及不稳定股骨转子间骨折患者，采用人工股骨头置换治疗是可行的，远期效果仍需继续观察。人工股骨头置换术后并发症发生率为13．3％，明显低于DHS组（P〈0．05）。人工关节置换术较内固定术明显缩短了卧床时间，减少了由于长期卧床导致的严重并发症及病死率。其治疗高龄、活动量小、预期寿命短、一般状况差的股骨转子间骨折患者有较明显的优势。
Objective To assess the clinical effects of hemi arthroplasty and dynamic hip screw （DHS） in elderly patients with unstable femoral intertrochanteric fracture. Methods Sixty-four elderly cases with unstable femoral intertrochanteric fracture were randomly divided into two groups. Thirty-four cases were treated with DHS and 30 cases were treated with hemiarthroplasty. The hip function and post operative complications were compared between the two groups. Results Sixty cases were followed up from 8 months to 7 years. Five cases died during follow-up period. Post operative complications occurred in 4 cases in hemiarthroplasty group and in 13 eases in DHS group （ P 〈 0.05 ）. The hip function according to Harris Scores was 71 - 96 （ 85.5 ± 5.3 ） in hemiarthroplasty group and 69 ± 92 （83.2 ± 6.6） in DHS group （P 〉 0.05 ）. Conclusions Hemiarthroplasty is a proper therapy for patients over 75 years with osteoporosis and unstable femoral intertrochanteric fracture. The long-term results need further follow-ups.
出处
《中国医药》
2010年第5期447-449,共3页
China Medicine
关键词
股骨转子间骨折
动力髋螺钉
髋关节置换
Intertroehanteric fracture
Dynamic hip screw
Hemiarthroplasty
