期刊文献+

人工股骨头置换术与股骨近端防旋髓内钉内固定治疗高龄不稳定性股骨转子间骨折的临床效果比较 被引量:15

Comparison of the clinical efficacy of artificial femoral head replacement and proximal femoral nail antirotation in the treatment of unstable intertrochanteric fractures of the femur in patients aged over 80 years old
下载PDF
导出
摘要 目的比较人工股骨头置换术与股骨近端防旋髓内钉(PFNA)内固定治疗高龄不稳定性股骨转子间骨折的临床疗效。方法回顾性分析2016年1月至2018年6月南京江北人民医院骨科中心符合标准的98例高龄(≥80岁)股骨转子间骨折患者的临床资料,根据手术方式分为人工股骨头置换组和PFNA组,比较两组术中出血量、住院费用、完全负重时间、术后髋关节Harris功能评分及术后并发症等。结果PFNA组术中出血量、住院费用少于人工股骨头置换组,而完全负重时间长于人工股骨头置换组,差异有统计学意义(P<0.05);人工股骨头置换组术后1、3、6、12个月髋关节Harris评分优于PFNA组,差异有统计学意义(P<0.05);两组围手术期并发症发生率差异无统计学意义(P>0.05),但PFNA组并发症发生率高于人工股骨头置换组。结论人工股骨头置换术和PFNA内固定治疗高龄不稳定性股骨转子间骨折均具有较好疗效,但对于存在严重骨质疏松、合并多种内科疾病、术前评估可耐受且期望值较高的患者,人工股骨头置换术后可进行早期下床康复锻炼,降低术后并发症发生率,显著改善髋关节功能。 Objective To compare the efficacy of artificial femoral head replacement and proximal femoral nail antirotation(PFNA)for treatment of unstable intertrochanteric fractures of the femur in patients aged over 80 years old.Methods A retrospective study was conducted in 98 patients who were 80 years old or over suffering unstable intertrochanteric fractures of the femur in our department from January 2016 to June 2018.Based on surgical procedures,the patients were divided into the PFNA group and the artificial femoral head replacement group.The intraoperative blood loss,medical expenses in hospital,the full weight bearing time,the Harris scores and incidence of postoperative complications were compared between the two groups.Results The intraoperative blood loss and medical expenses in the PFNA group were less than those in the artificial femoral head replacement group,while the full weight bearing time was later than that in the artificial femoral head replacement group,with statistically significant difference(P<0.05).The Harris scores of the artificial femoral head replacement group were superior to the PFNA group at 1 month,3 months,6 months and 12 months postoperatively,all with statistically significant difference(all P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05),but the incidence in the PFNA group was higher than that in the artificial femoral head replacement group.Conclusion Both procedures could be used in the treatment of unstable intertrochanteric fracture of femur,but artificial femoral head replacement may be more suitable in patients with severe osteoporosis,high expectations and medical comorbidity precluding large surgical trauma,as it can start early rehabilitation postoperatively,reduce the incidence of complications and improve hip function and the quality of life.
作者 刘小雷 王炎 田纪伟 丁志勇 LIU Xiaolei;WANG Yan;TIAN Jiwei;DING Zhiyong(Department of Orthopedics, Nanjing Jiangbei People’s Hospital, Nanjing 210048, China)
出处 《国际骨科学杂志》 2020年第5期312-317,共6页 International Journal of Orthopaedics
关键词 高龄 不稳定 股骨转子间骨折 股骨近端防旋髓内钉 人工股骨头置换 Elderly Instability Intertrochanteric fracture of femur Proximal femoral nail antirotation Artificial femoral head replacement
  • 相关文献

参考文献6

二级参考文献95

  • 1李增春,蔡俊丰,王振平,李国风,张振,朱文辉,尹峰,王予彬.高龄股骨粗隆间骨折手术治疗的风险与防范[J].中国矫形外科杂志,2005,13(24):1848-1850. 被引量:34
  • 2Nikolaou VS,Papathanasopoulos A,Giannoudis PV.What's newin the management of proximal femoral fractures[J].Injury,2008,39:12:1309-1318.
  • 3Liberati A,Altman DG,Tetzlaff J,et al.The PRISMA statementfor reporting systematic reviews and meta-analyses of studies thatevaluate health care interventions:explanation and elaboration[J].Ann Intern Med,2009,151:65-94.
  • 4Julian PT,Higgins SG.Cochrane Handbook for systematic reviewsof interventions 5.1.0[Updated March 2011] :the CochraneCollaboration,2011.
  • 5Xu YZ,Geng DC,Mao HQ,et al.A comparison of the proximalfemoral nail antirotation device and dynamic hip screw in thetreatment of unstable pertrochanteric fracture[J].J Int Med Res,2010,38:1266-1275.
  • 6Garg B,Marimuthu K,Kumar V,et al.Outcome of shortproximal femoral nail antirotation and dynamic hip screw forfixation of unstable trochanteric fractures:a randomisedprospective comparative trial[J].Hip International,2011,21:531-536.
  • 7Stem R,Lubbeke A,Suva D,et al.Prospective randomised studycomparing screw versus helical blade in the treatment of low-energytrochanteric fractures[J].Int Orthop,2011,35:1855-1861.
  • 8Zou J,Xu Y,Yang H.A comparison of proximal femoral nailantirotation and dynamic hip screw devices in trochanteric fractures[J].J Int Med Res,2009,37:1057-1064.
  • 9Simmonds MC,Higgins JP,Stewart LA,et al.Meta-analysis ofindividual patient data from randomized trials:a review of methodsused in practice[J].Clin Trials,2005,3:209-217.
  • 10Choy WS, Ahn JH, Ko JH, et al. Cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly patients[J] . Clin Orthop Surg, 2010, 2: 221-226.

共引文献219

同被引文献169

引证文献15

二级引证文献20

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部