微创股骨头置换和G-M-R捆扎技术治疗高龄股骨转子间骨折的临床观察

CLINCAL RESEARCH ON TECHNOLOGY OF MICRO - INSULT FEMORAL HEAD SUBSTITUTION AND G -M -R TIE UP TECHNIQUE ON ELD INTERTROCHANTERIC FRACTURE

目的评价股骨头置换治疗高龄(≥80岁)不稳定性股骨转子间骨折的临床疗效。方法手术治疗高龄不稳定性股骨转子间骨折患者106例,随机分为治疗组56例,采用人工股骨头置换。对照组50例。采用钉板和股骨近端钉固定。结果 2组患者在负重时间、Harris评分、髋内翻发生和植入物失效等方面差异有统计学意义(P<0.01),治疗组优于对照组;在手术时间、术中出血量等方面差异无统计学意义(P>0.05)。结论合并严重骨质疏松的高龄不稳定性股骨转子间骨折患者行微创人工关节置换术相对内固定手术,具有术后负重活动早、功能恢复良好,可避免长期卧床所致诸多并发症等优点,是一种比较理想的治疗手段。

Objective To estimate the clinic effect of femoral head substitution on eld （ ≥ 80 years） instable intertrochanteric fracture. Methods A total of 106 cases of eld instable intertrochanteric fracture were divided into two groups, treatment group were treated by artificial femoral head substitution, control group were treated by nail plank and femur proximate pinning. Results There were significant differences between two groups on weight loading, Harris score, coxa vara proceeding and implant failure （P 〈0.01 ）. Treatment group were better than control group; there was no statistical difference on operation time and blood volume while operation （ P 〉 0.05 ） . Conclusion Micro - insult femoral head substitution is an ideal therapeutic method with many advantages, such as early weight loading exercise, good recovery and avoiding long - term bed. It can be used in the treatment of instable intertrochanteric fracture for patients who are eld or combined with severe osteoporotic.