加长柄人工股头置换与InterTAN治疗高龄股骨粗隆间骨折的疗效比较

Efficacy Comparison of the Long-stem Bipolar Femoral Head Replacement and Inter TAN in Treatment of Elder Patients with Unstable Intertrochanteric Fractures

目的：探讨加长柄人工股骨头置换与InterTAN内固定治疗高龄病人不稳定型股骨粗隆间骨折的临床疗效。方法：选取本院2013年1月-2014年8月手术的不稳定型股骨粗隆间骨折患者60例,根据手术方式的不同分为加长柄人工股骨头置换组（30例）和InterTAN内固定组（30例）,比较两组患者的手术时间、失血量、住院时间、术后完全负重时间、并发症发生率、髋关节Harris评分（HHS）。结果：全部患者术后随访13~15个月,加长柄人工股骨头组较InterTAN内固定组住院时间短、并发症发生率低、髋关节Harris评分（HHS）高、术后完全负重时间明显缩短,比较差异均有统计学意义（P〈0.05）;InterTAN内固定组较加长柄人工股骨头组置换手术时间短、失血量少,比较差异均有统计学意义（P〈0.05）。结论：对于老年不稳定型股骨粗隆间骨折,加长柄人工股骨头置换与InterTAN内固定都能达到良好疗效,两者均是较好的治疗方法。

Objective：To compare the clinical efficacy of long-stem bipolar femoral head replacement and Inter TAN in treatment of elder patients with unstable intertrochanteric fractures.Method：From January 2013 to August 2014,a total of 60 elder patients with unstable intertrochanteric fractures admitted to our hospital were retrospectively reviewed.All the cases were devided into long-stem bipolar femoral head replacement group（30 cases） or Inter TAN group（30 cases） according to the difference of their surgical procedures.The duration of operation,blood loss volume,hospital stays,postoperative completely weight-bearing time,incidence of complications and Harris hip score of the two groups were compared.Result：All 60 cases followed up for 13-15 months.The hospital stays and postoperative completely weight-bearing time of the long-stem bipolar femoral head replacement group was shorter than the Inter TAN group,and the incidence of complications was lower,the Harris hip score was higher than the Inter TAN group,the differences were statistically significant（P〈0.05）.The duration of operation in the Inter TAN group was shorter and the blood loss volume was less than the long-stem bipolar femoral head replacement group,the differences were statistically significant（P〈0.05）.Conclusion：The long-stem bipolar femoral head replacement and Inter TAN are both good method for the treatment of elder patients with unstable intertrochanteric fractures.