人工股骨头置换术治疗高龄重度骨质疏松股骨粗隆间粉碎性骨折的疗效观察

Effect of Artificial Femoral Head Replacement on Intertrochanteric Comminuted Fracture in Elderly Patients With Severe Osteoporosis

目的探讨对高龄重度骨质疏松股骨粗隆间粉碎性骨折,临床治疗上,经人工股骨头进行置换对疾病资料的效果。方法纳入60例患者随机分成两组,30例对照组采取全麻下股骨近端髓内钉内固定术治疗,30例实验组实施全麻下人工股骨头置换术治疗,对比两组手术指标、随访12个月髋关节Harris评分及术后并发症情况。结果各指标表现均存在差异,其中实验组手术时间更长、术中出血量更多,同对照组进行比较具有统计学差异,术后的下床及住院两项时间指标则是实验组更短,与对照组比较有统计学差异(P<0.05);术后6个月、12个月两组Harris评分均较术前提高,实验组显著高于对照组(P<0.05);两组术后并发症总发生率差异无统计学意义(P>0.05)。结论人工股骨头的置换手术方式应用于高龄重度骨质疏松股骨粗隆间粉碎性骨折治疗桑,优势在于对髋关节功能改善满意且并发症少,但存在手术创伤大的缺陷。

Objective To investigate the effect of artificial femoral head replacement on the disease data of senile severe osteoporosis intertrochanteric fracture.Methods 60 patients were randomly divided into two groups,30 cases in the control group were treated with proximal femoral nail fixation under general anesthesia,and 30 cases in the experimental group were treated with artificial femoral head replacement under general anesthesia.The operation indexes,Harris score of hip joint and postoperative complications were compared between the two groups.Results There were significant differences in the indexes of the experimental group,such as longer operation time and more intraoperative blood volume,compared with the control group,the time of getting out of bed and hospitalization in the experimental group was shorter,and the difference was also significant(P<0.05);Harris evaluation of 6 months and 12 months after operation in the two groups was significant The score of the experimental group was significantly higher than that of the control group(P<0.05);there was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Artificial femoral head replacement in the treatment of senile severe osteoporosis intertrochanteric comminuted fracture has the advantages of satisfactory improvement of hip joint function and less complications,but it has the defect of large surgical trauma.