CAJ | 학술논문

目的探讨动力髋螺钉(DHS)内固定与人工股骨头置换术治疗高龄股骨转子间骨折的方法及治疗效果.方法 64例高龄不稳定股骨转子间骨折患者完全随机分为2组,DHS组34例行DHS内固定治疗,关节组30例行人工股骨头置换治疗.比较2组术后并发症及髋关节功能.结果 60例获随访,时间8个月～7年,随访期内死亡5例.关节组发生并发症4例,DHS组发生13例,差异有统计学意义(P＜0.05).患髋功能评定采用Harris评分法:关节组71～96(平均85.5±5.3)分,DHS组69～92(平均83.2±6.6)分,差异无统计学意义(P＞0.05).结论对于年龄≥75岁,骨质疏松及不稳定股骨转子间骨折患者,采用人工股骨头置换治疗是可行的,远期效果仍需继续观察.人工股骨头置换术后并发症发生率为13.3%,明显低于DHS组(P＜0.05).人工关节置换术较内固定术明显缩短了卧床时间,减少了由于长期卧床导致的严重并发症及病死率.其治疗高龄、活动量小、预期寿命短、一般状况差的股骨转子间骨折患者有较明显的优势.
목적 탐토동력관라정(DHS)내고정여인공고골두치환술치료고령고골전자간골절적방법급치료효과.방법 64례고령불은정고골전자간골절환자완전수궤분위2조,DHS조34례행DHS내고정치료,관절조30례행인공고골두치환치료.비교2조술후병발증급관관절공능.결과 60례획수방,시간8개월～7년,수방기내사망5례.관절조발생병발증4례,DHS조발생13례,차이유통계학의의(P＜0.05).환관공능평정채용Harris평분법:관절조71～96(평균85.5±5.3)분,DHS조69～92(평균83.2±6.6)분,차이무통계학의의(P＞0.05).결론 대우년령≥75세,골질소송급불은정고골전자간골절환자,채용인공고골두치환치료시가행적,원기효과잉수계속관찰.인공고골두치환술후병발증발생솔위13.3%,명현저우DHS조(P＜0.05).인공관절치환술교내고정술명현축단료와상시간,감소료유우장기와상도치적엄중병발증급병사솔.기치료고령、활동량소、예기수명단、일반상황차적고골전자간골절환자유교명현적우세.
Objective To assess the clinical effects of hemi arthroplasty and dynamic hip screw (DHS) in elderly patients with unstable femoral intertrochanteric fracture.Methods Sixty-four elderly cases with unstable femoral intertrochanteric fracture were randomly divided into two groups.Thirty-four cases were treated with DHS and 30 cases were treated with hemiarthroplasty.The hip function and post operative complications were compared between the two groups.Results Sixty cases were followed up from 8 months to 7 years.Five cases died during follow-up period.Post operative complications occurred in 4 cases in hemiarthroplasty group and in 13 cases in DHS group (P＜0.05).The hip function according to Harris Scores was 71～96 (85.5±5.3) in hemiarthroplasty group and 69～92 (83.2±6.6) in DHS group (P＞0.05).Conclusions Hemiarthroplasty is a proper therapy for patients over 75 years with osteopomsis and unstable femoral intertrochanteric fracture.The long-term results need furthor follow-ups.