内固定技术和人工髋关节置换术在老年股骨转子间不稳定性骨折伴严重骨质疏松患者中的效果评价

Evaluation of Internal Fixation Technique and Artificial Hip Joint Replacement in Elderly Patients with Intertrochanteric Unstable Fracture and Severe Osteoporosis

目的研究亚洲型股骨近端防旋髓内钉(PFNA-Ⅱ)和人工全髋关节置换术(THA)在老年股骨转子间不稳定性骨折伴严重骨质疏松患者中的应用效果。方法回顾性总结60例行PFNA-Ⅱ和60例行THA治疗患者,比较治疗效果。结果两组的手术时间、术中出血量和下地负重时间比较,差异均无统计学意义(P>0.05)。两组的围术期并发症发生率比较无差异(P>0.05)。两组的Harries功能评分均随时间延长而提高,THA组于随访6月和12月评分明显高于PFNA-Ⅱ组,差异有统计学意义(P<0.05);随访12月THA组的髋关节功能优良率高于PFNA-Ⅱ组(P<0.05)。两组的随访并发症发生率比较无差异(P>0.05)。结论 PFNA-Ⅱ和THA在老年股骨转子间不稳定性骨折伴严重骨质疏松患者中均有较好的应用效果。

Objective To compare clinical effects of asian proximal femoral nail anti rotation(PFNA-Ⅱ)or artificial hip joint replacement(THA)in elderly patients with intertrochanteric unstable fracture and severe osteoporosis.Methods A total of 60 consecutives for PFNA-Ⅱ and other 60 patients for THA treatment were enrolled for the retrospective analysis.Results The operation time,blood loss during operation and time of weight-bearing walk in the two groups were no statistical differences(P>0.05).The perioperative complications rate in the two groups were no statistical difference,either(P>0.05).But,the Harries scores were gradually increasing with time extended,and they after six and twelve months during follow-up in THA group were significantly higher than PFNA-Ⅱ group(P<0.05).What′s more,the excellent rate of hip joint function after twelve months in THA group was more(P<0.05).While,the complications rate during follow-up in the two groups was no statistical difference(P>0.05).Conclusion It is better effects of PFNA-Ⅱ and THA for elderly patients with intertrochanteric unstable fracture and severe osteoporosis.