高龄股骨粗隆间骨折半髋关节置换与股骨髓内钉治疗临床比较研究被引量：10

Study between hemiarthroplasty and proximal femoral nail anti-rotation for senile patients with intertrochanteric fracture

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摘要目的观察半髋关节置换与防旋型股骨近端髓内钉内固定治疗高龄患者股骨粗隆间骨折的临床效果。方法笔者2011年3月～2013年8月使用半髋置换术及防旋型股骨近端髓内钉治疗高龄股骨粗隆间骨折39例,其中男性17例,女性22例;年龄70～93岁,平均（75.9±4.7）岁。患者经过长达1年以上的随访,回顾性分析两组的手术时间、术后卧床时间、住院时间、术后1年内的髋关节功能、手术出血量、术后引流量及并发症。结果半髋关节置换组在手术时间、术后卧床时间、住院时间及术后1年内的髋关节功能方面均优于防旋型股骨近端髓内钉组,差异有统计学意义（P〈0.05）。防旋型股骨近端髓内钉组手术出血量及术后引流量方面均优于半髋关节置换组,差异有统计学意义（P〈0.05）。两组在并发症方面未见明显差异（P〉0.05）。结论半髋置换和防旋型股骨近端髓内钉均适用于高龄股骨粗隆间骨折,均获得了较为满意的疗效,两者具有不同的优缺点,临床中应该按照个体化的原则进行治疗。 Objective To compare the clinical efficacy between hemiarthroplasty and femoral nail anti-rota-tion（PFNA）for senile patients with intertrochanteric fracture.Methods Totally 39 cases of senile intertrochanteric fracture from Mar.2011 to Aug.2013 were performed hemiarthroplasty and PFNA.Seveteen were male and 22 were female with an average age of （75.9 ±4.7）years （70-93 year）.All patients had been followed-up for more than one year.Retrospective analysis was carried out about the therapeutic effect of the two groups.Results Hemiar-throplasty group had better results than PFNA group in operation time,postoperative bed time,hospitalization time and Harris score（P〈0.05）.The PFNA group excelled than the hemiarthroplasty group in operation bleeding vol-ume and postoperative drainage volume（ P〈0.05） .There was no significant difference between the two groups in complications（P〉0.05）.Conclusion Hemiarthroplasty and PFNA are both suitable for intertrochanteric fracture among the elderly people.Both have advantages and disadvantages.Clinical treatment should follow the principle of individualization.

作者杨光毅李越

机构地区雅安市中医医院骨科

出处《创伤外科杂志》 2015年第5期434-437,共4页 Journal of Traumatic Surgery

关键词股骨粗隆间骨折关节置换髓内钉 femoral intertrochanteric fracture joint replacement intra-medullary nail

分类号 R683.42 [医药卫生—骨科学]

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1Park - Wyllie LY, Mamdani MM, Juurlink DN, et al. Bi- sphosphonate use and the risk of subtroehanteric or femoral shaft fractures in order women[J].JAMA, 2011,305 ( 8 ) : 783 - 789.
2胥少汀,葛宝丰,徐印坎.实用骨科学[M].北京:人民军医出版社,2012:1862.
3Gamradt SC, Gelber J, Zhang AL. Shoulder function and pain level after revision of failed reverse shoulder replace-ment to hemiarthroplasty [ J ]. Int J Shoulder Surg, 2012,6 (2) :29 -35.
4范远俊,向阳,李正云,陈增刚.改进型防旋股骨近端髓内钉与人工股骨头置换术治疗老年股骨粗隆间骨折疗效比较[J].创伤外科杂志,2014,16(3):264-264. 被引量：16
5朱裕昌,孙业青,孙健,蔡新宇,蔡郑东.人工关节置换治疗内固定失败的股骨转子间骨折[J].中华创伤杂志,2011,27(12):1071-1075. 被引量：12
6Johansson T. Internal fixation compared with total hip re- placement for displaced femoral neck fractures : a minimum fifteen - year follow - up study of a previously reported ran- domized trial[ J]. J Bone Joint Surg ( Am), 2014,96 ( 6 ) : e46.
7周源,王静成,胡翰生.高龄股骨颈骨折全髋与半髋方式的选择[J].中国组织工程研究,2014,18(17):2637-2642. 被引量：21
8Lin CC,Huang SC, Ou YK, et al. Survival of patients aged over 80 years after Austin - Moore hemiarthroplasty and bi- polar hemiarthroplasty for femoral neck fractures [ J ]. Asian J Surg,2012,35 (2) :62 - 66.
9Fan L, Dang X, Wang K. Comparison between bipolar hemi- arthroplasty and total hip arthroplasty for unstable intertro- chanteric fractures in elderly osteoporotic patients [ J ]. Plos 0ne.2012.7(6) :e39531.
10Lee PC, Hsieh PH, Chou YC, et al. Dynamic hip screws for unstable intertrochanteric fractures in elderly patients -encouraging resuhs with a cement augmentation tech- nique [ J ]. J Trauma,2010,68 ( 4 ):954 - 964.

二级参考文献49

1徐瑞生,吴洁石,薛骏,包聚良,王立邦.股骨粗隆间骨折内固定失败后的假体置换治疗[J].中国矫形外科杂志,2006,14(6):416-418. 被引量：16
2Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg (Am), 2001, 83(5) :643 -650.
3Winemaker M, Gamble P, Petruccelli D, et al. Short term out- comes of total hip arthroplasty after complications of open reduction internal fixation of hip fracture. J Arthroplasty, 2006, 21 (5) : 682 - 688.
4Srivastav S, Mittal V, Agarwal S. Total hip arthroplasty following failed fixation of proximal hip fractures. Indian J Orthop, 2008, 42(3) :279 -286.
5D' Arrigo C, Perugia D, Carcangiu A, et al. Hip arthroplasty for failed treatment of proximal femoral fractures. Int Orthop, 2010, 34(7) :939-942.
6Buly RL. Conversion total hip arthroplasty for failed hip fracture repair. Curr Opin Orthop, 2004, 15( 1 ) :22 -26.
7Haidukewych GJ, Berry DJ. Hip arthroplasty for salvage of failed treatment of intertrochanteric hip fractures. J Bone Joint Surg (Am), 2003, 85(5) :899 -904.
8Jacofsky D J, Haidukewych GJ, Zhang H, et al. Complications and results of arthroplasty for salvage of failed treatment of malig- nant pathologic fractures of the hip. Clin Orthop Relat Res, 2004, (427) :52 -56.
9Mabry TM, Prpa B, Haidukeqych GJ, et al. Long - term results of total hip arthroplasty for femoral neck fracture nonunion. J Bone Joint Surg (Am), 2004, 86(10) :2263-2267.
10Sharvill RJ, Ferran NA, Jones HG, et al. Long- stem revision prosthesis for salvage of failed fixation of extracapsular proximal femoral fractures. Acta Orthop Belg, 2009, 75 (3) :340 - 345.