半髋关节置换治疗老年A2型股骨转子间骨折的可行性分析

Feasibility analysis of hemiarthroplasty in the treatment of type A2 intertrochanteric fractures in the elderly

目的研究分析半髋关节置换治疗老年A2型股骨转子间骨折的可行性。方法选取从2012年11月～2018年1月我院收治的老年A2型股骨转子间骨折患者77例作为研究对象,随机分成参照组和实验组;其中参照组33例,采用锁定钢板内固定术;实验组34例,采用半髋关节置换术。观察比较两组患者手术的各项指标、治疗前和治疗后6个月髋关节功能以及治疗后并发症发生情况。结果实验组患者的手术时间、手术出血量、术后引流情况以及下地负重时间均显著优于参照组(均P <0.05)。手术前两组患者Harris评分无显著差异(P> 0.05);手术后6个月,实验组患者Harris评分改善情况显著优于参照组(P> 0.05)。实验组的并发症发生率为5.88%,显著低于参照组的30.3%(P <0.05)。结论对老年A2型股骨转子间骨折患者实施半髋关节置换术治疗,能够显著优化手术相关指标,改善髋关节功能,降低并发症发生率。

Objective To study the feasibility of hemiarthroplasty in the treatment of type A2 intertroehanterie fractures in the elderly. Methods A total of 77 elderly patients with intertroehanterie fractures of type A2 who treated in our hospital from November 2012 to January 2018 were selected as study objects, and were randomly divided into referenee group（33 cases） and experimental group（34 cases）. The reference group was given loeking plate internal fixation, the experimental group was treated with hemiarthroplasty. The indexes of operation, hip function and complications were observed and compared between the two groups before and 6 months af）er treatment. Results The operative time, blood loss, postoperative drainage, and start time of postoperative weight-bearing exercise in the experimental group were significantly better than those in the reference group（all P 〈 0.05）. There was no significant difference in Harris seore between the ）wo groups before surgery（P 〉 0.05）. Six months after surgery, the improvement in the Harris score was significantly better in the experimental group than in the reference group （P 〈 0.05）. The complication rate in the experimental group was 5.88%, which was signifieantly lower than that（30.3%） in the reference group（P 〈 0.05）. Conclusion Treatment of elderly type A2 femoral intertrochanteric fractures with hemiarthroplasty can significanlly improve surgically-related indicators, improve hip function, and reduce the incidence of complications.