人工髋关节置换治疗股骨粗隆间骨折疗效分析

Effect analysis of hip replacement used for patients with intertrochanter fracture of femur

目的探讨人工髋关节置换术治疗股骨粗隆间骨折的疗效分析。方法回顾性分析从2016年1月至2018年12月收治在郑州市第一人民医院的209例股骨粗隆间骨折病人,其中男95例,女114例,40~99岁(平均75岁)。根据Evans分类,13例Ⅰ型,33例Ⅱ型,56例Ⅲ型,76例Ⅳ型,31例Ⅴ型。术前合有并高血压的143例,冠心病的101例,Ⅱ型糖尿病的130例,肝肾功能不全的91例,肺功能不全85例。其中动力髋螺钉(dynamic hip screw,DHS)固定52例,股骨近端防旋髓内钉(proximal femoral nail antirotion,PFNA)固定71例,人工髋关节置换86例。结果患者全部得到随访,均为6~24个月的随访时间,平均随访时间12个月。人工髋关节置换组在术后负重时间、并发症的发生率以及Harris评分等方面优于其余2组,差异有统计学意义(P<0.05)。结论髋关节置换术对于治疗老年患者股骨粗隆间骨折拥有内固定达不到的疗效,能够尽快的减轻患者的病痛以及提高患者的生活质量,尽量少的避免并发症的发生。

Objective To investigate the clinical effect of hip replacement used for patients with intertrochanter fracture of femur.Methods Totally 209 intertrochanteric hip fractures patients with complete clinical data were retrospectively analyzed,who were treated in Zhengzhou First People’s Hospital from January 2016 to December 2018 including 95 males and 114 females aged 40-99 years old(average 75 years old).According to Evans classification,there were 13 cases of typeⅠ,33 cases of typeⅡ,56 cases of typeⅢ,76 cases of typeⅣ,and 31 cases of typeⅤ.Preoperative hypertension 143 cases,101 cases of Coronary atherosclerotic heart disease,130 cases of diabetes,91 cases of liver and kidney function is not complete,85 cases of pulmonary insufficiency.Among those patients,52 were treated with conservative treatment,71 received dynamic hip screw(DHS)fixation,31 underwent proximal femoral nail antirotion(PFNA)fixation,and 86 were treated with hip replacement.Results All the patients were followed up for 6-24 months(average 12 months).There were significant differences Among the three groups in postoperative weight,incidence of complications and Harris scores(P<0.05).the hip replacement group were better than The other two groups.Conclusion Hip replacement in the treatment of senile femoral intertrochanteric fracture can achieve the effect that internal fixation couldn’t do,and it can reduce the suffering of patients as soon as possible and improve the quality of life of the elderly,and reduce the occurrence of complication.