两种内固定治疗方案用于老年股骨粗隆间并粗隆下骨折疗效比较

Comparison of Efficacy of Two Different Kinds of Internal Fixation Treat-ment of Elderly Intertrochanteric Fractures

目的探讨解剖型锁定钢板与动力髋螺钉(DHS)内固定方案治疗老年股骨粗隆间并粗隆下骨折临床疗效及安全性差异。方法研究对象方便选取该院2010年4月—2015年4月收治的老年股骨粗隆间并粗隆下骨折患者共80例,以随机区组法分为A组(40例)和B组(40例),分别采用DHS和解剖型锁定钢板内固定方案治疗;比较两组患者多项指标。结果 A组手术时间为(103.10±7.35)min,术后卧床时间为(18.46±1.35)d;B组手术时间为(99.41±6.90)min,术后卧床时间为(21.08±1.42)d。两组患者手术时间和术中失血量比较差异无统计学意义(P>0.05);B组患者术后卧床时间显著长于A组(P<0.05);B组患者术后髋关节Harris评分优良率显著优于A组(P<0.05);B组患者术后并发症发生率显著低于A组(P<0.05)。结论相较于DHS内固定方案,解剖型锁定钢板内固定方案治疗老年股骨粗隆间并粗隆下骨折可有效提高骨折愈合效果,促进髋关节功能恢复,并有助于降低术后并发症发生风险。

Objective To discuss the efficacy and security of fixation with anatomic locking plate or DHS in treatment of elderly patients with intertrochanteric fractures. Methods Convenient selection 80 elderly patients who had been treated in our hospital from April 2010 to April 2015 for intertrochanteric fractures were selected as research objects. They were divid-ed into group A and group B. DHS was given to group A. anatomic locking plate was given to group B. Indicators were ob-served. Results The operation time of group A was （103.10±7.35） min and the postoperative bed time was （18.46±1.35） weeks. The operation time of group B was （99.41±6.90） min and the postoperative bed time was （21.08±1.42） weeks. The variation in operation time and amount of bleeding during operation had no statistical significance（P〉0.05）. B group of pa-tients with postoperative bed rest time was significantly longer than that in group A （P〈 0.05）; B group of patients with postoperative Harris hip score the excellent and good rate was significantly better than that of group A （P〈 0.05）; B group of patients with postoperative complications rate was significantly lower than that of group A （P 〈 0.05）. Conclusion Anatomic locking plate will enhance the efficiency of fracture and Reduce the risk of postoperative complications.