人工髋关节置换术与内固定术治疗老年不稳定股骨粗隆间骨折的疗效和安全性

Efficacy and Safety of Artificial Hip Replacement and Internal fixation in the Treatment of Unstable Femoral Intertrochanteric Fractures in the Elderly

目的探讨老年不稳定股骨粗隆间骨折治疗中人工髋关节置换术与内固定术的疗效和安全性。方法回顾性选取2020年1月—2021年12月该院骨科老年不稳定股骨粗隆间骨折患者94例,依据手术方法分为人工髋关节置换术组、动力髋螺钉固定术组,各47例,统计分析两组疼痛程度、髋关节功能、日常生活活动能力、生活质量、临床疗效、围术期指标、术后并发症发生情况。结果术后,人工髋关节置换术组患者的NRS评分低于动力髋螺钉固定术组,Harris评分、MBI评分、QOL-BREF评分均高于动力髋螺钉固定术组,差异有统计学意义(P<0.05)。人工髋关节置换术组患者的髋关节功能恢复优良率93.62%(44/47)高于动力髋螺钉固定术组78.72%(37/47),差异有统计学意义(χ^(2)=4.374,P<0.05)。人工髋关节置换术组围术期指标均优于动力髋螺钉固定术组,且术后并发症发生率明显低于动力髋螺钉固定术组,差异有统计学意义(P<0.05)。结论老年不稳定股骨粗隆间骨折治疗中人工髋关节置换术的疗效和安全性较内固定术高。

Objective To investigate the efficacy and safety of artificial hip replacement and internal fixation in the treatment of unstable intertrochanteric fractures of the elderly.Methods A total of 94 elderly patients with unstable femoral intertrochanteric fractures in the department of orthopedics of the hospital from January 2020 to December 2021 were retrospectively selected.According to the surgical method,they were divided into artificial hip replace‐ment group and dynamic hip screw fixation group,with 47 cases in each group.The pain level,hip function,activi‐ties of daily living,quality of life,clinical efficacy,perioperative period indicators,postoperative complications were statistically analyzed in the two groups.Results After operation,the NRS score of the artificial hip replacement group was lower than that of the dynamic hip screw fixation group,and the Harris score,MBI score and QOL-BREF score were higher than those of the dynamic hip screw fixation group,and the differences were statistically significant(P<0.05).The excellent and good rate of hip function recovery in the artificial hip replacement group was 93.62%(44/47)higher than that in the dynamic hip screw fixation group 78.72%(37/47),and the difference was statistically sig‐nificant(χ^(2)=4.374,P<0.05).The perioperative indicators in the artificial hip replacement group were better than those in the dynamic hip screw fixation group,and the postoperative complication rate was significantly lower than that in the dynamic hip screw fixation group,the difference was statistically significant(P<0.05).Conclusion The effi‐cacy and safety of artificial hip replacement in the treatment of unstable intertrochanteric fractures in the elderly are higher than that of internal fixation.