股骨近端防旋髓内钉和人工股骨头置换术治疗高龄骨质疏松不稳定股骨转子间骨折的临床效果比较

Clinical comparison of proximal femoral anti-rotation intramedullary nail and artificial femoral head replacement for unstable femoral intertrochanteric fracture in elderly patients with osteoporosis

目的观察比较股骨近端防旋髓内钉和人工股骨头置换术的应用治疗对高龄骨质疏松不稳定股骨转子间骨折的临床效果。方法择取医院收治的股骨转子间骨折患者100例,随机分为观察组和对照组,每组50例。对照组行股骨近端防旋髓内钉治疗,观察组行人工股骨头置换术,比较2组患者术中、术后指标,术后髋关节功能评分及不良反应发生情况。结果观察组手术时间短于对照组、术中出血量少于对照组、术后VAS评分低于对照组,而下床活动时间长于对照组(P <0. 01);观察组术后3、6、12个月Harris评分均高于对照组(P <0. 01);观察组不良反应发生率为4. 0%,低于对照组的18. 0%(P <0. 05)。结论人工股骨头置换术的治疗效果较好,且安全性较高,值得临床推广应用。

Objective To compare the clinical effects of proximal femoral anti-rotation intramedullary nail and artificial femoral head replacement in the treatment of unstable femoral intertrochanteric fractures in elderly patients with osteoporosis.Methods 100 cases of intertrochanteric fracture of femur were randomly divided into observation group and control group,50 cases in each group.The control group was treated with proximal femoral anti-rotation intramedullary nail,while the observation group was treated with artificial femoral head replacement.The intraoperative and postoperative indexes,hip function scores and adverse reactions were compared between the two groups.Results The operation time of the observation group was shorter than that of the control group,the amount of bleeding during operation was less than that of the control group,the VAS score after operation was lower than that of the control group,and the time of getting out of bed was longer than that of the control group(P<0.01).The Harris score of observation group was higher than that of control group 3,6 and 12 months after operation(P<0.01).The incidence of adverse reactions was 4.0%in the observation group,which was lower than18.0%in the control group(P<0.05).Conclusion Artificial femoral head replacement is effective and safe,which is worthy of clinical application.