摘要
目的 :探讨股骨近端解剖型锁定刚板治疗老年骨质疏松性EvanⅢ、Ⅳ型股骨粗隆间骨折的临床效果。方法 :回顾性分析66例老年EvanⅢ、Ⅳ型股骨粗隆间骨折伴骨质疏松患者,随机分为对照组和观察组,每组各33例。观察组采用切开复位股骨近端解剖型锁定钢板内固定治疗,对照组采用股骨近端髓内钉治疗。观察手术时间、术中出血量、术后下地时间、住院费用及并发症发生情况,并行Sander评分,术后1、3、6、12月分别复查X片观察骨折愈合情况和内固定位置。结果 :观察组手术时间和住院费用明显低于对照组[(67.2±5.8)min比(78.7±7.3)分);(1.2±0.5)万比(1.9±0.8)万],而术中出血量和术后下地时间高于对照组[(262.4±10.1)m L比(174.2±8.8)m L;(3.1±0.6)月比(2.4±0.7)月],差异有统计学意义。12月末次随访,两组Sander评分未见统计学差异,均未发生髋内翻、内固定松动、深静脉血栓等并发症。骨折愈合时间观察组(4.6±0.3)个月,高于对照组(3.8±0.4)月。结论:股骨近端解剖型锁定刚板治疗老年骨质疏松性EvanⅢ、Ⅳ型股骨粗隆间骨折手术时间短、术中出血量高、住院费用低,术后髋关节功能佳;但术后下地时间及骨折愈合时间延长,须谨慎选择患者。
Objective To investigate the anatomical proximal femur in the treatment of osteoporotic Evan Ⅲ, Ⅳ intertrochanteric fractures of the clinical effects of locking rigid board. Methods 66 casesge(>65y) with osteoporosis and Evan Ⅲ, Ⅳ intertrochanteric fractures in our hospital were retrospective analyzed. They were randomly divided into control group and observation group, each group of 33 cases. The observation group was treated with open reduction and proximal femoral locking plate fixation,and the control group with the proximal femur intramedullary nail fixation. The operation time, bleeding volume, postoperative ambulation time, cost of hospitalization and complications were observed. The Sander score were calculated after 12 months. The X-ray were reviewed after 1, 3, 6, 12 months respectively. Results The operation time and cost of hospitalization in the observation group were significantly lower than the control group [(67.2±5.8)min vs(78.7±7.3)min);(1.2±0.5) million vs(1.9±0.8) million], the operative bleeding and postoperative time in e observation group were higher thanhe control group [(262.4±10.1) m L vs(174.2±8.8) m L;(3.1±0.6) months vs(2.4±0.7) months], the difference was statistically significant. There was no significant difference of the Sander score after the 12 th month follow-up between the two groups There were no coxa vara, internal fixation loosening, deep vein thrombosis in the two groups. The healing time of fracture in the observation group was higher than that of the control group [(4.6±0.3) months vs(3.8±0.4) months]. Conclusion the anatomical proximal femur in the treatment of osteoporotic Evan Ⅲ, Ⅳ femoral intertrochanteric fracture with shorter operation time, less bleeding, hospitalization expenses low locking rigid plate, but the postoperative ambulation time and fracture healing time, must be careful selection of patients.
出处
《湖南师范大学学报（医学版）》
2015年第1期113-115,共3页
Journal of Hunan Normal University(Medical Sciences)
