人工关节置换术与内固定术治疗老年股骨转子间骨折的效果比较

Effect comparison of artificial joint replacement and internal fixation in the treatment of intertrochanteric fracture in the elderly

目的比较人工关节置换术与内固定术治疗老年股骨转子间骨折的效果。方法选取2017年1~12月我院收治的72例老年股骨转子间骨折患者作为研究对象,采用随机数字表法分为观察组和对照组,每组各36例。观察组患者给予人工关节置换术,对照组患者给予内固定术。比较两组患者的切口长度、术中出血量、手术时间、术后下地时间、术后并发症以及术后12个月的髋关节Harris评分。结果观察组患者的切口长度、手术时间长于对照组,术中出血量多于对照组,术后下地时间短于对照组,差异均有统计学意义(P<0.05);观察组患者的术后并发症总发生率低于对照组,差异有统计学意义(P<0.05);观察组患者术后12个月的疼痛、功能评分及Harris总分均高于对照组,差异有统计学意义(P<0.05);两组患者的畸形与活动度评分比较,差异无统计学意义(P>0.05)。结论人工关节置换术在老年股骨转子间骨折患者中的治疗效果显著,术后恢复快,并发症发生率较低,值得临床推广应用。

Objective To compare the effect of artificial joint replacement and internal fixation in the treatment of intertrochanteric fracture in the elderly.Methods A total of 72 elderly patients with femoral intertrochanteric fracture who were treated in our hospital from January to December in 2017 were selected as the research subjects,they were divided into observation group and control group by random number table method,with 36 cases in each group.The patients in the observation group were treated with artificial joint replacement,while the patients in the control group were treated with internal fixation.The incision length,intraoperative hemorrhage,operative time,postoperative time of descent,postoperative complications and the Harris score at 12 months after operation of the two groups were compared.Results The incision length and operation time of the patients in the observation group were longer than those in the control group,the intraoperative hemorrhage was more than that in the control group,and the operation time was shorter than that in the control group,the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The pain,function score and Harris total score of the observation group 12 months after operation were higher than those of the control group,the differences were statistically significant(P<0.05).There were no significant differences in deformity and activity scores between the two groups(P>0.05).Conclusion The artificial joint replacement is effective in the treatment of intertrochanteric fractures in the elderly,and the postoperative recovery is rapid and the incidence of complications is low.It is worthy of popularizing and applying in clinical practice.