老年人股骨粗隆间骨折治疗的临床比较研究

Clinic Comparative Study for Senile Intertrochanteric Femoral Fracture

目的:比较三种不同方法治疗老年人股骨粗隆间骨折的临床疗效。方法:回顾性分析我院2001年1月-2010年6月分别采用DHS、人工股骨头置换术及PFNA治疗46例、39例和19例老年股骨粗隆间骨折患者的临床资料。结果:全部病例均获随访,平均随访时间10.2月。DHS内固定患者、双极人工股骨头置换患者和PFNA组患者Harris评分分别为83.6分、90.2分和89.2分,优良率分别为82.6%、94.8%和84.2%。人工股骨头置换组在平均手术时间和平均术中出血和术后12小时引流量方面优于DHS内固定组(P<0.05);PFNA组手术时间、出血量、平均输血以及平均住院日均较DHS、人工双极股骨头置换组少(P<0.05)。结论:三种方法治疗老年人股骨粗隆间骨折均有效,但必须注意手术指征和技巧。

Objective： To compare the clinical effect of intertrochanteric femoral fracture in the aged used three different methods. Methods： The clinical data of aged patients with intertrochanteric femoral fractures treated by 46 cases DHS and 39 cases replacement of artificial femoral head with bone cement and 19 cases PFNA were analyzed retrospectively from Jan 2001 to Jul 2010. Results： All patients were follow-up,the average tbllow-up time was 10.2 months. Harris score and the rate of good quality in DHS group 83.6 and 82.6%,replacement of artificial femoral head with bone cement group 90.2 and 94.8%, PFNA group 89.2 and 84.2%.Artificial femoral head replacement group had better effect than DHS group on operation time,the amount of bleeding,hip function （Harris score）,P〈 0.05. PFNA group had better effect than DHS group and artificial femoral head replacement group in operation time, amount of bleeding and hospital time,P〈 0.05. Conclusion：The treatment of intertrochanteric fracture in the aged patients by three methods is effective, but indications and techniques of the operation must be paid attention to.