加长柄人工股骨头治疗高龄患者股骨粗隆间骨折的疗效分析

Clinical Study of Long-stem Bipolar Hemiarthroplasty in Treating Intertrochanteric Fracture of Aged Patients

目的分析比较加长柄人工股骨头与锁定加压钢板(LCP)治疗高龄股骨粗隆间骨折的疗效。方法回顾性分析82例高龄股骨粗隆间骨折患者的临床资料,将37例患者行加长柄人工股骨头置换纳入置换组,45例行LCP内固定纳入股骨近端髓内钉(PFN)组,比较两组患者手术过程、术后卧床时间、并发症及功能恢复等指标。结果 1)置换组切口长度、手术时间、术中出血量及输血量均显著高于PFN组(P<0.05或<0.01),但置换组术后卧床时间显著低于PFN组(P<0.01)。2)两组内科相关并发症发生率相似(P>0.05),但置换组相关并发症显著低于PFN组(P<0.05)。3)置换组的Harris评分稍高于PFN组,但差异无统计学意义(P>0.05)。结论加长柄人工股骨头置换手术虽损伤大,易加重原有内科疾病,但置换组相关并发症发生率低,是治疗高龄患者股骨粗隆间骨折的有效方法。

Objective Analysis and compare the clinical effect of long-stem bipolar hemiarthroplasty and LCP （Locking compression plate） in treating intertrochanteric fracture of aged patients. Methods the data of 82 aged patients with intertrochanteric fracture was studied retrospectively. Based on different treatments, 37 patients were divided into hemiarthroplasty group, while 45 patients were taken into PFN group. Comparison was made between two groups in respect of demographic and injury variables. Results 1） PFN group has shorter incision length, operative time, less blood loss, fewer units of blood transfusion than hemiarthroplasty group. However, hemiarthroplasty group has shorter lying bed time than PFN group. 2）There was no obvious difference between two groups in general complications, but hemiarthroplasty group has less implant complications than PFN group. 3）There was no obvious difference between two groups in Harris Score. Conclusion long stem bipolar hemiarthroplasty in treating intertrochanteric fracture of aged patients is an effective method, has less implant complications but has higher operation iniury.