组配型假体初次治疗高龄不稳定股骨转子间骨折的临床效果研究

The Clinical Observation on the Type with Prosthesis in the First Treatment of Unstable Intertrochanteric Fracture in the Elderly

目的:探讨高龄不稳定性股骨转子间骨折采用组配型半髋关节置换治疗的临床效果。方法:对2015年1月—2017年3月收治的38例高龄股骨转子间骨折患者资料进行分析,其中组配型假体置换组(A组)17例,防旋股骨近端髓内钉(PNFA)组(B组)21例。通过随访,观察手术时间、出血量、住院时间、首次下地负重时间、Harris评分、并发症,对比近期两种手术方法在治疗高龄股骨转子间Ⅲ、Ⅳ型骨折的差异。结果:手术时间、首次下地负重时间、术中透视次数,A组<B组(P<0.05),出血量,A组>B组(P<0.05);近期Harris评分,A组>B组(P<0.05)。结论:组配型假体置换是治疗高龄股骨转子间Ⅲ、Ⅳ型骨折的理想方法。

Objective：The study aims to explore the clinical effect of type with prosthesis in treatment of unstable intertrochanteric fracture in the elderly.Methods：38 cases with unstable intertrochanteric fracture in the elderly treated from Jan.in 2015 to March in 2017 were analyzed with the clinical data,among whom 17 cases accepted type with prosthesis（group A）and 21 cases accepted proximal femoral nail antirotation（PNFA,group B）.Surgery time,hospitalization time,hemorrhage amount,ambulation time,Harris hip score,postoperative complications were compared between the two group,and the differences of clinical effect on treating III and IV type of unstable intertrochanteric fracture in the elderly were also compared.Result：In terms of the surgery time,ambulation time,and perspective times during surgery,group A shows lower than group B（P〈0.05）;while hemorrhage amount in group A is more than group B（P〈0.05）;and Harris hip score of group A is higher than group B（P〈0.05）.Conclusion：Type with prosthesis is an ideal choice in treatment of III and IV type of unstable intertrochanteric fracture in the elderly.