摘要
目的对比研究内固定术与人工关节置换术治疗老年股骨转子间骨折的疗效。方法将2016年1月—2018年6月该院收治的56例老年股骨转子间骨折患者分为人工关节置换术组26例和内固定术组30例。人工关节置换术组行人工关节置换术治疗,内固定术组行PFNA内固定术治疗。对比2组患者的手术时间、术中出血量、卧床时间、住院时间、骨性愈合时间、髋关节功能及术后并发症。结果人工关节置换术组平均手术时间(76.45±7.45)min长于内固定术组(47.35±5.35)min,差异有统计学意义(t=8.353,P=0.021),术中出血量(418.24±45.28)mL多于内固定术组(254.35±24.45)mL,差异有统计学意义(t=10.782,P=0.003),但卧床时间(2.43±0.45)d及住院时间(17.47±3.24)d均短于内固定术组(5.15±1.02)d、(24.35±3.29)d,差异有统计学意义(t=7.435、8.432,P=0.030、0.018)。术后12个月,在髋关节功能优良率和术后并发症的总发生率上,人工关节置换术组依次为82.61%、11.5%,内固定术组依次为66.67%、26.67%,差异有统计学意义(χ^(2)=8.242、7.729,P=0.021、0.023)。结论相较于PFNA内固定术,人工关节置换术治疗下患者康复效果及对髋关节功能的改善效果更佳,且术后总并发症少,但手术时间长,出血量较多,对手术医师的专业性要求较高,具体实践中应根据患者的个体情况予以优化选择。
Objective To compare the effects of internal fixation and artificial joint replacement in the treatment of intertrochanteric fractures in the elderly.Methods From January 2016 to June 2018,56 elderly patients with femoral intertrochanteric fractures were divided into artificial joint replacement group with 26 cases and internal fixation group with 30 cases.The artificial joint replacement group was treated with artificial joint replacement,and the internal fixation group was treated with PFNA internal fixation.The operation time,intraoperative blood loss,bed time,hospitalization time,bone healing time,hip function and postoperative complications of the two groups were compared.Results The average operation time of the artificial joint replacement group was(76.45±7.45)min longer than that of the internal fixation group(47.35±5.35)min,the difference was statistically significant(t=8.353,P=0.021).The intraoperative blood loss was(418.24±45.28)mL more than the internal fixation group.The fixation group(254.35±24.45)mL,the difference was statistically significant(t=10.782,P=0.003),but the bed time(2.43±0.45)d and hospitalization time(17.47±3.24)d were shorter than the internal fixation group(5.15±1.02)d,(24.35±3.29)d,the difference was statistically significant(t=7.435,8.432,P=0.030,0.018).At 12 months after the operation,the rate of good hip function and the total incidence of postoperative complications were 82.61% and 11.5% in the artificial joint replacement group,and 66.67% and 26.67% in the internal fixation group,the difference was statistically significant(χ^(2)=8.242,7.729,P=0.021,0.023).Conclusion Compared with PFNA internal fixation,artificial joint replacement has better rehabilitation effect and improvement of hip joint function,and the total postoperative complications are less,but the operation time is longer and the blood loss is more.Physicians have high professional requirements,and the specific practice should be optimized according to the patient's individual situation.
作者
李晓明
LI Xiao-ming(Department of Orthopedics,Zouping Central Hospital,Binzhou,Shandong Province,256212 China)
出处
《系统医学》
2021年第5期82-84,139,共4页
Systems Medicine
关键词
老年股骨转子间骨折
内固定术
人工关节置换术
髋关节功能
并发症
Elderly femoral intertrochanteric fractures
Internal fixation
Artificial joint replacement
Hip joint function
Complications
