摘要
目的通过对使用全髋关节置换（totalhipreplacement，THR）以及微创动力髋螺钉（minimallyinvasivedynamichipserew，MIDHS）治疗伴有骨质疏松股骨转子间骨折的结果进行比较分析，探讨两者之间的差异。方法回顾性收集48例高龄股骨转子间骨折，采用THR（THR组，24例）或MIDHS（MIDHS组，24例）治疗，经过6个月以上的随访，比较两组在手术时间、术中出血、术后引流、术后髋部的功能评分及术后并发症等方面存在的差异。结果与MIDHS组比较，THR组手术花费时间长，术中出血及术后引流量多。THR组不同骨质疏松程度不同，但假体松动率无明显差异。MIDHS组骨质疏松不同导致内固定松动率差异明显。术后MIDHS组和THR组内置物松动率分别为33．3％、4．1％（P〈0．05）。术后6个月两组患髋功能评定无明显差异。结论为能获得早期更多功能恢复及较少的术后并发症，对于伴骨质疏松的转子间骨折患者，如果高龄且骨质疏松不明显可考虑行MIDHS，而年龄较轻但骨质疏松明显的可考虑行THR。
Objective To compare the outcomes of total hip replacement （THR） and minimally invasive dynamic hip screw （MIDHS） in treating osteoporotic femoral intertrochanteric fractures so as to discuss the differences of the two treatment methods. Methods A retrospective study was done on 48 elderly patients with femoral intertrochanterie fractures. All the patients were randomly treated with THR （THR group） and MIDHS internal fixation （MIDHS group）. After a follow-up of over six months, the two groups were compared concerning the operation time, intraoperative blood loss, postoperative drain- age, postoperative hip function, and postoperative complications. Results THR group had longer oper- ation time, larger volume of intraoperative bleeding and postoperative drainage as compared with the MIDHS group. The incidence of internal fixation loosening varied significantly with different degree of os- teoporosis in the MIDHS group, but not in the THR group. The loosening rate of the implants in the MIDHS and THR groups was 33.3% and 4.1% respectively, with significant difference. Functional eval- uation of hip showed no significant differences between the two groups six months postoperatively. Con- clusion For achieving earlier and better functional recovery and less postoperative complications in the management of osteoporotic femoral intertrochanteric fractures, MIDHS can be considered for the elderly patients with low degree of osteoporosis and THR for younger patients with high degree of osteoporosis.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2012年第8期718-721,共4页
Chinese Journal of Trauma
关键词
股骨骨折
髋骨折
骨质疏松
Femoral fractures
Hip fractures
Osteoporosis
