两种方法治疗不稳定型骨质疏松性股骨转子间骨折疗效比较

Comparison of two different therapies for elderly patients with unstable osteoporotic intertrochanteric femoral fracture

目的探讨内固定术和人工关节置换术治疗老年性不稳定型骨质疏松性股骨转子间骨折的临床疗效。方法对43例老年性不稳定型骨质疏松性股骨转子间骨折患者采用内固定术(23例)和人工关节置换术(20例)治疗,并对两种治疗方法的手术时间、术中出血量、并发症发生率、Harris评分及功能恢复评分(FRS)情况进行评估。结果 43例均顺利完成手术。患者均得到随访,时间18～25(20.3±2.3)个月。人工关节置换术组FRS、Harris恢复情况均优于内固定组(P<0.05),并发症发生率低于内固定组(P<0.05)。结论人工关节置换术治疗老年性不稳定型骨质疏松性股骨转子间骨折,疗效优于内固定术。

Objective To compare the effect of internal fixation and arthroplasty for elderly patients with unstable os- teoporotie intertrochanteric femoral fracture. Methods 43 cases of elderly patients with intertrochantefic femoral fractures were enrolled in the study to evaluate the therapy effect, operation time, amount of bleeding, amount of trans- fusion. 23 cases were treated by internal fixation, and the 20 cases were treated by hip replacement. Results All cases were followed up for 18 -25 （20. 3 ± 2. 3 ）months. Hip replacement group had better effect than interanl fixation on FRS, Harris and less complications （ P 〈 0. 05 ）. Conclusions Hip replacement in treatment of unstable osteopo- rotie intertrochanteric femoral tracture is better than internal fixation.