改良髋膝踝足矫形器与内固定术治疗高龄股骨粗隆间骨折合并感染患者的临床效果对比研究

Comparative study of clinical effects in patients with modified hip and knee bare foot orthoses and internal fixation of intertrochanteric fracture combined infections

目的研究改良髋膝踝足矫形器和内固定术在高龄股骨粗隆间骨折合并感染患者中的临床效果,为提高临床治愈率提供依据。方法选取2012年10月-2015年12月医院诊治40例高龄股骨粗隆间骨折合并感染患者资料进行分析,将患者根据随机数字表法分为两组,每组20例,对照组采用内固定术治疗,试验组采用改良髋膝踝足矫形器治疗,比较两组治疗效果。结果试验组患者平均住院时间、下地时间、住院费用以及治疗后愈合时间,显著短于对照组(P<0.05);两组患者治疗前Harris评分差异无统计学意义,试验组患者治疗后1个月及3个月Harris评分,显著高于对照组,差异有统计学意义(P<0.05);试验组患者治疗后并发症发生率为15.0%,显著低于对照组35.0%,差异有统计学意义(P<0.05)。结论高龄股骨粗隆间骨折合并感染患者治疗时与内固定术相比,改良髋膝踝足矫形器效果更理想,能促进骨折愈合,患者恢复快,值得推广应用。

OBJECTIVE To study the clinical effects in patients with modified hip and knee bare foot orthoses and internal fixation of intertrochanterie fracture combined infection, so as to provide evidence for improving clinical cure rate. METHODS A total of 40 cases of intertrochanteric fracture co-infected patients from Oct. 2012 to Dec. 2015 in the hospital were selected and got analysis for their clinical data, who were divided into two groups accord- ing to the random number method, 20 cases in each group. The control group used internal fixation for the treat- ment, the experimental group used the modified hip knee-ankle-foot orthosis therapy, and the therapeutic effects were compared. RESULTS In the experimental group, the average length of stay, ambulation time, hospital costs, and healing time after treatment was significantly shorter than the control group （P〈0.05）. Harris score before treatment in two groups of patients had no significant difference. Harris scores after one and three months treat- ment in experimental group were significantly higher than those in control group（P〈0.05）. Complication rate was 15.0% in the experimental group after treatment which was significantly less than 35.0% of the control group（P 〈0.05）. CONCLUSION Compared with the intertrochanteric fracture fixation, the improved hip knee-ankle-foot orthosis effect is more ideal to patients with with modified hip and knee bare foot orthoses and internal fixation of intertrochanteric fracture combined infection, which can promote healing, promote patient recovery, so it should be widely applied.