人工髋关节置换术与传统DHS治疗高龄股骨转子间不稳定性骨折

Hip Arthroplasty and DHS Internal Fixation for Treatment of Unstable Intertrochanteric Fracture in Elderly Patients

目的对比分析人工髋关节置换术与传统动力髋螺钉(DHS)治疗高龄患者股骨转子间不稳定性骨折的疗效。方法回顾分析2012年5月至2014年7月我院收治的高龄股骨转子间不稳定性骨折患者男26例,女36例;年龄(78.81±4.92)岁;左侧42例,右侧20例。随机分组,DHS内固定组17例,关节置换组45例。结果关节置换组在住院时间、手术时间、术中出血量、术后卧床时间及术后并发症方面明显优于DHS内固定组(均P<0.05),入选病例随访时间均达到1 a以上。结论人工髋关节置换术较传统DHS治疗高龄患者股骨转子间不稳定性骨折具有明显优势。

Objective To explore the efficacy of the treatment of unstable intertrochanteric fracture of aged people using hip arthroplasty compared with the dynamic hip screw(DHS)internal fixation.Methods 60 patients were involved including 26 cases of male and female 36 female cases,an average of ages(78.81±4.92),42 cases on the left side,20 cases on the right side,17 cases of DHS internal fixation and 45 cases of joint replacement during May 2012 to July 2014. Results All cases were followed up more than 1 year.Statistical analysis of observation indexes of two groups were made including the length of hospital stay,operation time,intraoperative blood loss,postoperative bed time and postoperative complications.The results showed that the hip arthroplasty group was significantly superior to the DHS internal fixation group(all P<0.05). Conclusion Compared with the DHS internal fixation,artificial hip replacement for treatment of aged people has obvious advantages in unstable intertrochanteric fracture.