人工股骨头置换治疗老年不稳定股骨粗隆间骨折的临床效果

Clinical effects of artificial femoral replacement on elderly patients with unstable femoral intertrochanteric fractures of femur

目的探讨人工股骨头置换治疗老年不稳定股骨粗隆间骨折的临床效果。方法选择100例老年不稳定股骨粗隆间骨折患者为研究对象,按照随机数表法将其分为观察组与对照组,每组50例。对照组给予防旋型股骨近端髓内钉(PFNA)治疗,观察组给予人工股骨头置换治疗,比较两组临床疗效、术后恢复情况及并发症。结果观察组术后下床时间、住院时间低于对照组(P<0.05);观察组优良率(90.00%)高于对照组(74.00%)(P<0.05);术后3、6个月时观察组Harris评分分别为(84.18±3.81)分、(91.45±2.29)分,高于对照组(P<0.05);观察组并发症发生率(6.00%)低于对照组(20.00%)(P<0.05)。结论老年不稳定股骨粗隆间骨折,采取人工股骨头置换治疗和有良好效果,从近期治疗效果来看,人工股骨头置换治疗效果更佳,可以减少患者卧床时间、下床时间,值得临床推广应用。

Objective To investigate the effect of artificial femoral replacement on elderly patients with unstable femoral intertrochanteric fractures of femur. Methods A total of 100 patients with unstable intertrochanteric fractures of femur were selected and divided into the observation group and the control group according to the random number table method,and with 50 cases in each group. The patients in the control group were treated with antirotation proximal femoral nail（ PFNA）,and the patients in observation group were treated with artificial femoral replacement. The clinical efficacy,postoperative recovery and complications were compared between the two groups. Results The postoperative ambulation time and hospitalization time of the patients in observation group were lower than those of the control group（ P 0. 05）; the excellent rate of the observation group（ 90%） was significantly higher than that of the control group（ 74%）（ P 0. 05）; the Harris score of the observation group were（ 84. 18 ± 3. 81） and（ 91. 45 ± 2. 29） in 3 months and 6 months after operation,which were higher than those of the control group（ P 0. 05）; the incidence of complication in observation group（ 6%） was significantly lower than that of the control group（ 20%）（ P 0. 05）. Conclusions Artificial femoral replacement therapy is effective on unstable intertrochanteric fractures in elderly,but artificial femoral replacement has shorterterm efficacy than PFNA,less complications,and it is worthy of clinical application.