不同内固定方法治疗高龄股骨粗隆间不稳定骨折临床效果对比分析

Comparative analysis of clinical effects of different internal fixation methods in the treatment of unstable intertrochanteric fractures of femur in elderly patients

目的分析不同内固定方法治疗高龄股骨粗隆间不稳定骨折的临床效果。方法将2009年8月至2012年11月本院收治的高龄股骨粗隆间不稳定骨折患者90例随机分为股骨近端解剖锁定钢板(LCP)组和动力髋螺钉(DHS)组,每组各45例。LCP组患者采用LCP内固定治疗,DHS组患者采用DHS内固定治疗,比较两组患者手术时间、术中出血量、术后愈合时间及并发症发生率。结果LCP组患者术中出血量少于DHS组(P<0.05),手术时间和术后愈合时间均短于DHS组(P<0.05),并发症发生率低于DHS组(P<0.05)。术前两组患者疼痛、功能、活动范围评分及总分比较均无明显差异(P>0.05);术后两组患者疼痛、功能、活动范围评分及总分均高于术前(P<0.05),且LCP组患者疼痛、功能评分及总分均高于DHS组(P<0.05),但两组患者活动范围评分比较无显著差异(P>0.05)。结论与DHS内固定治疗比较,LCP内固定治疗高龄股骨粗隆间不稳定骨折效果更佳,能有效改善患者髋关节功能,减少术中出血量,促进患肢功能恢复,安全性较高。

ObjectiveTo observe and analyze the clinical effects of different internal fixation methods in the treatment of unstable intertrochanteric fractures of femur in elderly patients.MethodFrom August 2009 to November 2012, 90 patients with unstable intertrochanteric fractures of femur in our hospital were randomly divided into LCP group and DHS group, 45 cases in each group, LCP group patients were treated with LCP internal ifxation, DHS group patients were treated with DHS internal ifxation, operation time, intraoperative blood loss, postoperative healing time and complication incidence were compared between the two groups.Result Intraoperative blood loss of LCP group was less than DHS group （P〈0.05）, operation time and postoperative healing time were shorter than DHS group （P〈0.05）, complication incidence was lower than DHS group （P〈0.05）. Preoperative, pain, function, range of motion scores and total scores of the two groups were not signiifcantly different （P〉0.05）, postoperative, pain, function and range of motion scores and total score were higher than preoperative （P〈0.05）; pain, function scores and total scores of LCP group were higher than DHS group （P〈0.05）, but there was no signiifcant difference in range of motion score between the two groups （P〉0.05）.ConclusionCompared with DHS internal ifxation, clinical effect of LCP internal ifxation in the treatment of unstable intertrochanteric fractures of femur in elderly patients is more better, it can effectively improve the hip function, reduce intraoperative blood loss, promote the recovery of limb function and more safety.