半髋置换与DHS治疗老年转子间骨折的比较

Comparison of Hemiarthroplasty and DHS in Treatment of Senile Intertrochanteric Fractures of the Elderly

目的探讨半髋置换术与动力髋螺钉内固定(DHS)治疗老年转子间骨折的临床效果。方法选取2010年6月至2012年6月平原县第一人民医院收治的老年转子间骨折患者82例,采用随机抽样法将患者分为半髋置换术组与DHS组,每组各41例,DHS组患者给予DHS治疗,半髋置换术组患者给予半髋置换治疗。比较两组患者的手术时间、术中出血量、术后并发症、最早负重时间及术后3、6个月的Harris评分。结果半髋置换术组患者的手术时间、术中出血量、最早负重时间及术后并发症发生率均显著少于DHS组患者(P<0.05);半髋置换术组术后3、6个月的Harris评分均显著高于DHS组(P<0.05)。结论半髋置换术治疗老年转子间骨折具有术中出血少、手术时间短、术后并发症发生率低、负重时间早等优点,效果显著,值得临床推广应用。

Objective To explore the clinical efficacy of half hip replacement and DHS for treatment of senile intertrochanteric fracture. Methods A total of 82 cases of elderly intertrochanteric fractures admitted to Pingyuan First People＇s Hospital from Jun. 2010 to Jun. 2012 ＇were selected and divided into half hip arthroplasty group and DHS group ,41 eases in each group,the DHS group was treated with DHS, the half hip arthreplasty group were treated with hemiarthreplasty replacement therapy. The operation time, intraoperative bleeding volume, postoperative complications, early weight bearing time and Harris score of 3,6 monthswere compared between the two groups. Results The operative time, amount of bleeding, the earliest load time and postoperative complications incidence of the half hip arthroplasty group were less than DHS group（ P 〈0.05 ）. Harris scores of postoperative 3,6 months of the half hip arthreplasty group were significantly higher than the DHS group （ P 〈 0.05 ）. Conclusion The Clinical efficacy of hemiarthroplasty for treatment of senile intertrochanteric fracture has significant effect with the advantages of less blood loss, shorter operative time, low complication rate, and early load time, thus is worthy of clinical application.