人工髋关节置换与DHS治疗老年不稳定股骨粗隆间骨折

DHS Iternal Fixation and Hip Replacement for Unstable Intertrochanteric Fractures in Elderly Patients

目的探讨DHS螺钉内固定手术和人工髋关节置换术治疗老年不稳定型股骨粗隆间骨折的临床疗效。方法2002年8月～2007年10月,收治老年不稳定股骨粗隆间骨折病人132例。分别采用DHS螺钉内固定和人工髋关节置换术方法治疗,对治疗效果、手术时间、术中出血、输血等情况进行评估。结果平均随访21.6个月,DHS内固定组71例,优良率69%,髋关节置换组61例,优良率86.8%。关节置换组在治疗效果、手术时间、术中出血等情况方面均优于DHS内固定组,P<0.05。结论采用人工髋关节置换术治疗老年股骨粗隆间骨折,操作简单、创伤小,避免了骨折不愈合及内固定失效等问题,并发症发生率低,可明显提高患者的生活质量。

Objective To compre the results and complications of DHS intemal fixation and hip replacement in the treatment of intertrochanteric fracture in elderly patients. Methods From August in 2002 to October in 2007, 132 elderly patients with unstable intertrochanteric fractures were collected to evaluate the therapy effect, operation time, amount of bleeding, amount of transfusion. Results The average follow-up time was 21.6 months, the 71 cases therapied by DHS, 69% had good functional restoration, the 61 cases therapied by hip replacement, 86.8% had good functional restoration. Hip replacment group had better effect than DHS group on operation time, the amount of bleeding, the amount of transfusion, P 〈0.05. Conclusion It is an effective method to treat the intertrochanteric fracture in elderly patients with hip replacement with satisfactoryresults. It can avoid the nonunion and interal fixation failure, decrease the complications, reduce the mortality, and improve the life quality in the elderly patients.