老年髋部骨折内固定与人工髋关节置换术的临床疗效比较

Comparative study of clinical curative effect of internal fixation and artificial joint replacement on the elderly hip fracture

目的比较内固定手术与人工髋关节置换术治疗老年髋部骨折的临床疗效。方法对横县人民医院2006年1月至2013年6月收治的108例老年髋部骨折患者的临床资料进行回顾性分析,其中60例患者采用内固定手术(内固定组),48例患者采用人工髋关节置换术(置换组),对两种手术患者手术一般情况和术后恢复情况进行比较。结果置换组患者术中出血量较内固定组明显增加,而负重时间和并发症的发生率明显少于内固定组,人工髋关节置换组在术后6个月和12个月的功能恢复达优率以及总体优良率均明显高于内固定组,差异有统计学意义(P<0.05)。结论人工髋关节置换术治疗老年髋部骨折可有效缩短术后卧床时间,尽早进行负重行走,且其近期疗效也明显优于内固定组,因此人工髋关节置换术可作为老年髋部骨折的首选治疗方案。

Objective To compare the treatment effects of the internal fixation and artificial joint replacement therapy on the eld-erly hip fracture. Methods The clinical data of 108 elderly patients with hip fracture treated in Hengxian people’s hospital from Janu-ary 2006 to June 2010 were analyzed retrospectively. Sixty patients were treated by internal fixation surgery（internal fixation group）, and 48 patients were treated by artificial hip replacement（displacement group）. The general condition of the surgery and postoperative recovery of the patients with two kinds of surgery were compared. Results The bleeding amount of patients in the displacement group was more than that of patients in the internal fixation group,and the load time and the incidence of complications was obviously less than that of the internal fixation group,and the optimal rate and overall fine rate of functional recovery in the artificial hip replacement group were significantly higher than that of the internal fixation group in 6 months and 12 months after surgery. The differences were statistically significant（P 〈 0.05）. Conclusion Hip arthroplasty in the treatment of senile hip fracture can effectively shorten the pa-tients’bed time,and take the postoperative walk as soon as possible,and the recent curative effect is obviously better than the internal fixation. So the hip arthroplasty can be used as the preferred treatment for elderly hip fracture.