人工髋关节置换术与内固定治疗高龄不稳定性股骨转子间骨折探讨

Investigation of artificial hip arthroplasty and internal fixation in the treatment of senile unstable intertrochanteric fracture

目的比较人工髋关节置换术及内固定治疗法在治疗高龄不稳定性股骨转子间骨折方面存在的优缺点。方法 72例高龄不稳定性股骨转子间骨折患者,依据治疗方式不同分为人工髋关节置换术组36例和内固定治疗组36例。比较两组的手术相关指标、并发症情况及髋关节功能Harris评分。结果两组患者住院时间差异无统计学意义(P>0.05),两组患者受伤前髋关节功能Harris评分差异无统计学意义(P>0.05),人工髋关节置换术组手术时间、术中出血量、住院费用均高于内固定治疗组,术后下地时间、并发症发生率低于内固定治疗组,人工髋关节置换术组患者手术后3个月及手术后6个月髋关节功能Harris评分均优于内固定治疗组,差异均有统计学意义(P<0.05)。结论人工髋关节置换术治疗高龄不稳定性股骨转子间骨折预后效果较好,值得临床推广应用。

Objective To compare advantages and disadvantages between artificial hip arthroplasty and internal fixation treatment in the treatment of senile unstable intertrochanteric fracture. Methods A total of 72 senile unstable intertrochanteric fracture patients were divided by different treatment methods into artificial hip arthroplasty group with 36 cases and internal fixation treatment group with 36 cases. Surgery related indexes, complications status and hip function Harris score were compared between the two groups. Results The difference between the two groups during admission had no statistical significance （P〉0.05）, and the difference of hip function Harris scores before injury between the two groups also had no statistical significance （P〉0.05）. The artificial hip arthroplasty group had higher operation time, intraoperative bleeding volume, and hospital cost than the internal fixation treatment group. It had lower postoperative activity time and incidence of complications than the internal fixation treatment group, and its hip function Harris scores in 3 and 6 months after operation were all better than the internal fixation treatment group. Their differences all had statistical significance （P〈O.05）. Conclusion Artificial hip arthroplasty in treating senile unstable intertrochanteric fracture has good prognosis effect, and this method is worthy of clinical promotion and application.