ADHLP与加压空心钉治疗老年股骨粗隆间EvansI型骨折的比较

Comparison between anatomical dynamic hip lock plate and compresive hollow needle in the treatment of the Evans I intertrochanteric fracture in the elderly

目的分析用解剖型髋动力带锁钢板(ADHLP)与加压空心钉治疗老年股骨粗隆间Evans I型骨折的治疗效果,比较两者的优缺点。方法回顾性分析我院自2008年03月至2014年05月收治的并获随访的老年股骨粗隆间Evans I型骨折患者38例,采用ADHLP组与加压空心钉组各19例,观察两组手术时间、出血量、临床愈合时间、手术后Harris评分等指标。结果加压空心钉组手术时间较短、术中及术后出血量较少(P<0.05),但ADHLP组临床愈合时间短(P<0.05),术后12个月Harris评分高(P<0.05)。结论在老年股骨粗隆间EvansⅠ型骨折患者耐受手术条件下,选择ADPHL与加压空心钉治疗各有优势。

Objective To analysis of anatomical dynamic hip locking plate（ADHLP） and cannulated compression screw in treatment of Evans I femoral intertrochanteric fractures in the elderly,comparing their advantages and disadvantages. Methods Thirty-eight elderly patients with Evans I intertrochanteric fracture treated and followed up in our hospital from Mar 2008 to May 2014, were selected and allocated by the ADHLP group（n =19） and the cannulated compression screw group（n =19） according to the surgical procedure. The operation duration, amount of bleeding, clinical healing duration after operation, Harris score and complications were observed in the two groups. Results The patients in cannulated compression screw group showed less bleeding, shorter operation time, but longer clinical healing time and higher Harris scores than those in ADHLP group（P〈0.05）.Conclusion ADPHL and cannulated screw approaches display their respective advantages in treatment of the elderly with intertrochanteric fractures Evans Ⅰ if the patients can tolerate the operation.