锁定钢板+钛缆对髋关节置换术后假体周围骨折的治疗效果及安全性分析

Analysis of Treatment Effect and Safety of Locking Plate and Titanium Cable on the Periprosthetic Fractures after the Hip Joint Replacement

目的分析髋关节置换术后假体周围骨折患者应用钛缆+锁定钢板的效果和安全性。方法抽取2015年3月—2017年9月在该院治疗的髋关节置换术后假体周围骨折患者122例,按入院顺序分乙组和甲组,每组61例。均采用锁定钢板治疗,研究甲组加用钛缆,对比患者的髋关节评分、临床情况、手术效果。结果甲组的Harris评分(58.14±2.31)分、手术出血量(401.21±12.52)m L、骨折愈合时间(142.21±9.36)d都优于乙组的的Harris评分(40.25±1.87)分、手术出血量(567.41±14.52)m L、骨折愈合时间(178.52±12.63)d,差异有统计学意义(t=47.013、67.705、18.040,P=0.000,0.000,0.000)。甲组的手术总优良率(88.52)%大于乙组的手术总优良率(49.18%),差异有统计学意义(χ~2=22.015,P=0.000)。乙组手术时间(113.25±16.52)min短于甲组(116.35±15.47)min,但差异无统计学意义(t=1.070,P=0.287)。结论在髋关节置换术后假体周围骨折患者中,钛缆+锁定钢板可明显改善患者的髋关节功能,手术优良率很高,具有一定的安全性。

Objective To analyze the treatment effect and safety of locking plate and titanium cable on the periprosthetic fractures after the hip joint replacement. Methods 122 cases of patients with periprosthetic fractures after the hip joint replacement in our hospital from March 2015 to September 2017 were selected and divided into two groups with61 cases in each according to the admission order, both groups used the locking plate for treatment, the research group used the titanium cable, and the hip joint score, clinical situation and operation effect were compared between the two groups. Results The Harris score, operation bleeding amount, and fracture healing time in the group A were better than those in the group B, [（58.14 ±2.31）,（401.21 ±12.52）m L,（142.21 ±9.36）d vs（40.25 ±1.87）points,（567.41 ±14.52）m L,（178.52±12.63）d], and the differences were statistically significant（t=47.013,67.705,18.040,P=0.000,0.000,0.000）, and the total excellent and good rate in the group A was higher than that in the surgery group,（88.52% vs 49.18%）, and the difference was statistically significant（χ~2=22.015,P=0.000）, and the operation time in the group B was shorter than that in the group A, [（113.25±16.52）min vs（116.35±15.47）min], and the difference was not statistically significant（t=1.070,P =0.287）. Conclusion The locking plate and titanium cable can obviously improve the hip joint function of patients with periprosthetic fractures after the hip joint replacement, and the operation excellent and good rate is high, with a certain safety.