摘要
[目的]分析比较半髋关节置换与DHS内固定治疗高龄不稳定型股骨转子间骨折的疗效,探讨治疗高龄不稳定型股骨转子间骨折的合理治疗方法。[方法]回顾性分析2002年6月～2005年10月期间接受半髋关节置换或DHS内固定治疗且具有完整资料的126例高龄股骨转子间骨折。其中半髋关节置换组53例,DHS内固定组73例;均合并有多系统内科疾病,且伴有严重骨质疏松;按改良Evens-Jensen分型,均为不稳定型骨折。比较2种治疗方法在手术时间、术中或术后输血量、术后卧床时间、术后并发症发生率及术后1年St.Michael髋关节评分等方面的指标。[结果]半髋关节置换组和DHS内固定组的平均随访时间分别为16、18个月。半髋关节置换组与DHS内固定组相比,术后卧床时间明显缩短、手术并发症发生率明显降低、术后1年关节功能评分明显增高,两者的差异具有显著性意义(P<0.05)。但两组的手术时间和输血量却无显著性差异(P>0.05)。[结论]骨水泥型半髋关节置换具有允许术后早期完全负重活动、并发症发生率低和功能恢复满意等优点,是治疗高龄不稳定型股骨转子间骨折的较合理的手术方法。
[Objective] To discuss a reasonable treatment for unstable intertrochanteric hip fractures in senile patients by comparing the effects of hemiarthroplasty and DHS fixation. [ Method ] Totally 126 intertrochanteric hip fractures in senile patients with complete clinical data were retrospectively analyzed ,who were treated with hemiarthroplasty or DHS fixation from June 2002 to October 2005. Of the 126 patients,53 were treated with hemiarthroplasty,73 were treated with DHS fixation. All of them had multiple medical co-morbidities and were combined with severe osteoporosis. According to modified Even-Jensen classification, all of them belonged to unstable fractures. Comparison was made between the two treated groups in terms of operative time, blood transfusion during or after surgery, time for bed rest postoperatively, postoperative complications and St. Michael hip score one year after surgery. [ Result]The average duration of follow-up for hemiarthroplasty and DHS fixation was 16 and 18 months respectively. Compared with the group of DHS fixation, the group of hemiarthroplasty experienced shorter time for bed rest postoperatively, fewer postoperative complications and higher St. Michael score 1 year after surgery, and the differences between two groups had statistical significance （ P 〈 0.05 ）. Whereas the differences in operative time and blood transfusion between two groups were of no statistical significance （ P 〉 0.05 ）. [ Conclusion ] Cemented hemiarthroplasty has the advantages of allowing early full weight bearing after surgery,low complication rate and satisfactory functional recovery. It is a reasonable treatment for unstable intertrochanteric hip fractures in senile patients.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第14期1055-1058,共4页
Orthopedic Journal of China
