全髋置换与人工双极股骨头置换治疗老年不稳定型股骨粗隆间骨折的效果比较

Comparison of Total Hip Replacement and Artificial Bipolar Femoral Head Replacement in the Treatment of Unstable Intertrochanteric Fractures in the Elderly

目的:比较全髋置换术(THA)与人工双极股骨头置换术(BA)治疗不稳定型股骨粗隆间骨折的效果。方法:将2004年6月-2010年12月在笔者所在医院治疗的94例70岁以上不稳定型股骨粗隆间骨折的患者分为两组,即THA组与BA组,术后进行随访,比较两组疗效。结果:THA组手术时间、手术失血量、输血量及住院费用均显著高于BA组,差异均有统计学意义(P<0.05)。而两组间住院时间、主要并发症、髋关节功能恢复、髋关节疼痛、翻修率及死亡率比较,差异均无统计学意义(P>0.05)。THA组存在5例髋臼脱位,BA组无髋臼脱位发生。结论:针对不稳定型老年股骨粗隆间骨折,BA相对于THA而言,手术时间短、手术输血量及输血量少、住院费用少,具有更好的疗效。

Objective：To compare the effects of total hip arthroplasty（THA） and artificial bipolar femoral head replacement（BA） in the treatment of unstable intertrochanteric fractures.Method：94 cases of 70 years old or more unstable intertrochanteric fracture in our hospital from June 2004 to December 2010 were divided into two groups,THA group and BA group,postoperative follow-up, compared the two groups of curative effect.Result：There were no significant differences in the length of stay, major complications, hip function recovery, hip pain, revision rate and mortality rate between the two groups（P〉0.05）.The operation time,blood loss,blood transfusion and hospitalization costs of the THA group were significantly higher than those in BA group, the differences were statist-ically significant（P〈0.05）.In the THA group, there were 5 cases of acetabular dislocation,and no acetabular dislocation occurred in the BA group.Conclusion：For unstable intertrochanteric fracture of the elderly, BA relative to THA, the operation time is short, the amount of blood transfusion and blood transfusion, less hospital costs, has a better curative effect.