两种术式治疗不同年龄段老年股骨转子间不稳定型骨折的疗效对比

Comparison of two methods in treatment of senile unstable intertrochanteric fracture in different ages

目的对比两种术式治疗不同年龄段老年股骨转子间不稳定型骨折的效果。方法将我院骨科收治的190例老年股骨转子间不稳定型骨折患者,随机分为动力髋组(动力髋螺钉内固定术)及人工置换组(人工股骨头置换术),各95例。根据年龄将2组患者各分为60岁~70岁组、71岁~80岁组、81岁~90岁组。比较2组不同年龄段患者手术情况、疗效优良率及并发症发生率。结果 2组各年龄段手术时间比较,差异无统计学意义(P>0.05);人工置换组各年龄段术中出血量及术后下床锻炼时间均明显少于动力髋组,疗效优良率均明显高于动力髋组,并发症发生率显著低于动力髋组,差异有统计学意义(P<0.05)。结论在不同年龄段老年股骨转子间不稳定型骨折治疗中,人工股骨头置换术优势显著,与动力髋螺钉内固定术相比,手术安全性更高,术后恢复更快,髋关节功能更佳。

Objective To compare the effects of two methods in treatment of senile unstable intertrochanteric fracture in different ages.Methods 190 patients with senile unstable intertrochanteric fracture in the department of orthopedics were selected,and they were random Ly divided into dynamic hip screw group and artificial replacement group,95 cases in each group. According to age,the two groups were divided into 60-70 group,71-80 group and81-90 group. The operation,effective rate,incidence of complications in two groups with different ages were compared.Results The operation time in two groups with different ages had no statistical difference（P〈0.05）;The intraoperative bleeding volume,postoperative leaving bed time in artificial replacement group were less than those in dynamic hip screw group,the effective rate was higher than dynamic hip screw group,and the incidence of complications was lower than dynamic hip screw group（P〈0.05）.Conclusion Artificial femoral head replacementin treatment of senile unstable intertrochanteric fracture in different ages is more effective,compared with internal fixation with dynamic hip screw,it has higher safety,quick recovery and better hip joint.