高龄股骨粗隆间粉碎性骨折47例临床分析

Clinical Analysis of 47 Senile Patients with Intertrochanteric Femoral Comminuted Fracture

目的:探讨高龄股骨粗隆间粉碎性骨折的治疗方法及其疗效。方法:回顾性分析2008年3月-201 1年12月分别采用经皮加压钢板(PCCP)内固定和人工股骨头置换治疗的高龄股骨粗隆间粉碎性骨折患者47例的临床资料,比较PCCP组(n=19)和人工股骨头置换组(n=28)的手术时间、出血量、住院时间和髋关节功能。结果:PCCP组的手术时间、出血量明显少于人工股骨头置换组,但住院时间明显长于人工股骨头置换组,P均<0.05;PCCP组和人工股骨头置换组术后1年髋关节功能的优良率分别为94.7%(18/19)和92.9%(26/28),无显著性差异,P>0.05。结论:PCCP内固定和人工股骨头置换治疗高龄股骨粗隆间粉碎性骨折均有效,须严格掌握其适应证和术中操作技巧。

Objective：To explore the treatment methods and the clinical effect for senile patients with intertroehanteric femoral comminuted fracture. Methods ：The clinical data of senile patients with intertrochanteric femoral comminuted fracture treated by PCCP and artificial femoral head replacement from Mar 2008 to Dec 2011.The operation duration, blood loss, hospitalization time and hip joint function were compared between the PCCP group（n= 19） and artificial femoral head replacement group （n=28）. Results：Compared with the artificial femoral head replacement group, the operation duration ,blood loss were significantly lower and hospitalization time longer in the PCCP group. The rate of good functional restoration was 94.7% （18/19） in the PCCP group, and 92.9%（26/28） in the artificial femoral head replacement group after operation 1 year. The clinical effect was no significant different between the two groups, P〉0.05. Conclusion： Both PCCP or artificial femoral head replacement are effective to senile patients with intertrochanteric femoral comminuted fracture, but the indications and techniques of the operation must be pay attention to.