全髋关节置换、双动股骨头置换和髓内钉固定治疗高龄股骨粗隆间骨折患者的效果

Effect of total hip replacement, double action femoral head replacement and intramedullary nail fixation in the treatment of elderly patients with intertrochanteric fractures

目的比较全髋关节置换、双动股骨头置换和髓内钉固定治疗高龄股骨粗隆间骨折患者的效果。方法选择2015年6月至2017年6月我院81例高龄股骨粗隆间骨折患者为研究对象,根据治疗方式不同分为全髋组、双动组以及髓内钉组,每组27例。比较三组的治疗效果、隐性出血量和预后情况。结果三组治疗优良率无显著差异(P>0.05)。全髋组的隐性失血量和失血比例显著优于双动组和髓内钉组,双动组的隐性失血量和失血比例显著优于髓内钉组,差异具有统计学意义(P<0.05)。全髋组的预后情况显著优于双动组和髓内钉组,差异具有统计学意义(P<0.05),双动组与髓内钉组无显著差异(P>0.05)。结论采用全髋关节置换治疗高龄股骨粗隆间骨折患者,能明显减少隐性出血量,且改善预后,具有良好的临床应用价值。

Objective To compare the effect of total hip replacement, double action femoral head replacement and intramedullary nail fixation in the treatment of elderly patients with intertrochanteric fractures. Methods From June 2015 to June 2017, a total of 81 elderly patients with intertrochanteric fractures in our hospital were selected as the research objects, which were divided into total hip group, double action group and intramedullary nail group according to different treatment methods, with 27 cases in each group. Treatment effects, recessive blood loss volume and prognosis conditions among the three groups were compared. Results There were no significant differences in the excellent and good rates of treatment among the three groups(P>0.05). The volume and proportions of recessive blood loss in the total hip group were significantly better than those in the double action group and intramedullary nail group, the volume and proportion of recessive blood loss in the double action group were significantly better than those in the intramedullary nail group, the differences were statistically significant(P<0.05). Prognosis conditions in the total hip group were significantly better than those in the double action group and intramedullary nail group, the differences were statistically significant(P<0.05). There were no significant differences in prognosis conditions between the double action group and intramedullary nail group(P>0.05). Conclusion The use of total hip replacement in the treatment of elderly patients with intertrochanteric fractures can significantly reduce recessive blood loss volume and improve the prognosis. It has good clinical application values.