PFNA与人工股骨头置换术治疗老年不稳定型股骨粗隆间骨折的临床效果观察

Clinical Effect Observation of PFNA and Artificial Femoral Head Replacement in Treatment of Elderly Unstable Femur Intertrochanteric Fractures

目的探讨PFNA与人工股骨头置换术治疗老年不稳定型股骨粗隆间骨折的临床效果。方法选择2016年7月至2018年1月我院收治的不稳定型股骨粗隆间骨折老年患者共74例,分为观察组和对照组各37例。观察组患者采用PFNA内固定术进行治疗,对照组患者给予人工股骨头置换术进行治疗。结果观察组患者的术中出血量明显多于对照组(P<0.05),术后下床活动时间则明显短于对照组(P<0.05),但观察组的手术时间明显长于对照组(P<0.05)。术后半年,观察组患者的Harris评分明显高于对照组(P<0.05);术后1年,两组患者的Harris评分无显著性差异(P>0.05)。结论人工股骨头置换术是治疗老年不稳定型股骨粗隆间骨折的理想术式,有利于患者尽早下床活动,促进髋关节功能恢复。

Objective to investigate clinical effect of PFNA and artificial femoral head replacement in treatment of elderly unstable femur intertrochanteric fractures. Methods choose 74 cases elderly unstable intertrochanteric fractures patients treated in our hospital from July 2016 to January 2018, divide them into observation and control group, 37 cases in each. Observation group was treated with PFNA internal fixation, and control group with artificial femoral head replacement. Results bleeding amount of observation group was significantly more than control group（P〈0.05）, and ambulation time after operation was significantly shorter than control group（P〈0.05）, operation time of observation group was significantly longer than control group（P〈0.05）. After half a year, Harris scores of observation group were significantly higher than control group,（P〈0.05）. One year after operation, Harris scores difference showed no significance between two groups（P〉0.05）. Conclusion artificial femoral head replacement is an ideal method in treatment of elderly unstable femur intertrochanteric fracture, which is conductive to earlier ambulation and promote recovery of hip joint function.