双极人工股骨头置换治疗老年不稳定股骨粗隆间骨折

Bipolar artificial femoral head replacement for treatment of elderly unstable intertrochanteric fractures

目的探讨双极人工股骨头置换治疗老年不稳定股骨粗隆间骨折的临床疗效。方法将82例老年不稳定股骨粗隆间骨折患者随机分为2组,每组41例,对照组采用动力髋螺钉内固定术治疗,观察组采用双极人工股骨头置换术治疗,比较2组手术时间、术中出血量及下地活动时间,患者出院后随访1年,比较术后1个月、3个月、6个月、12个月时2组髋关节Harris评分,记录并比较患者并发症发生情况。结果观察组手术时间、术中出血量及下地活动时间均小于对照组,差异有统计学意义(P<0.05);2组术后1个月、3个月Harris评分差异有统计学意义,观察组优于对照组,术后6月、12月差异无统计学意义(P>0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论双极股骨头置换术操作简单、创伤小、并发症少,有利于患者早期下床活动和髋关节功能的恢复,适合老年不稳定型股骨粗隆间骨折的治疗。

Objective To investigate the clinical effect of bipolar artificial femoral head replacement in the treatment of elderly patients with unstable intertrochanteric fractures. Methods 82 elderly patients with unstable intertrochanteric fractures were randomly divided into two groups with 41 cases in each group. The control group was treated with dynamic hip screw internal fixation, and the observation group was treated with bipolar artificial femoral head replacement. The operation time, bleeding volume and ambulation time were compared, and all the patients were followed up for one year. Harris scores of the two groups at 1 month, 3 months, 6 months, and 12 months after operation were compared, and the incidence of complications were recorded and compared. Results The operation time, bleeding volume and ambu-lation time of the observation group were less than the control group with a statistically significant difference （P〈0. 05）;Harris scores of the 2 groups at 1 month and 3 months after operation were of significant difference, while there was no significant difference at 6 months, and 12 months after operation （P〉0. 05）. The incidence of complication of the observation group was lower than that of the control group, the difference was statistically significant （P〈0. 05）. Conclusion Bipolar femoral head replacement has the advantages of simple operation, less trauma and complications. It is conducive to the early ambulation of patients and the recovery of hip function, and it is suitable for elder-ly patients with unstable femoral intertrochanteric fracture.