摘要
目的前瞻性比较人工股骨头置换与动力髋螺钉（DHS）内固定治疗老年股骨转子间不稳定骨折的中期临床疗效。方法1999年9月-2003年4月共治疗61例老年股骨转子间不稳定骨折患者，随机分为两组，29例患者采用人工股骨头置换术，32例患者采用DHS内固定术。随访4—8年。结果采用人工股骨头置换与DHS内固定两组患者的关节功能、出血量以及输血量接近。采用人工股骨头置换术患者平均手术时间为65．5min，平均住院时间为21．5d，平均下地时间为7．5d，术后并发症发生率为14％，死亡率为17％。和DHS相比，人工股骨头置换术患者住院时间和手术时间更短，下地负重更早，术后并发症更少，死亡率更低。结论对于不稳定转子间骨折的老年患者采用人工股骨头置换术具有比较理想的临床疗效，且关节功能恢复效果与采用DHS内固定术接近。
Objective To prospectively compare artificial femoral head replacement with dynamic hip screw （DHS） internal fixation in terms of treatment of unstable intertrochanteric fractures in the elderly. Methods Sixty-one elderly patients with intertrochanteric fractures who were treated from September 1999 to April 2003 and followed up for 4-8 years were randomized into two treatment groups, ie, artificial femoral head replacement （ Group A） and DHS internal fixation （ Group B）. Of all, 29 patients were treated with artificial femoral head replacement and 32 with DHS internal fixation. Result There were no significant differences in terms of knee function, blood loss and transfused blood volume between two groups. In Group A, average operation time was for 65.5 minutes, average hospital stay for 21.5 days, average weight-bearing time for 7.5 days, incidence rate of postoperative complication for 14% and mortality rate of 17%, either of indices was better than that in Group B. Conclusion For elderly patients with an unstable intertrochanteric femoral fracture, artificial femoral head replacement can provide satisfactory clinical outcomes and has similar functional recovery of the knee to that of DHS internal fixation.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2007年第11期817-820,共4页
Chinese Journal of Trauma
