中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2012年
8期
718-721
,共4页
丁红%许晓跃%许昕%诸苏杭
丁紅%許曉躍%許昕%諸囌杭
정홍%허효약%허흔%제소항
股骨骨折%髋骨折%骨质疏松
股骨骨摺%髖骨摺%骨質疏鬆
고골골절%관골절%골질소송
Femoral fractures%Hip fractures%Osteoporosis
目的 通过对使用全髋关节置换(total hip replacement,THR)以及微创动力髋螺钉(minimally invasive dynamic hip screw,MIDHS)治疗伴有骨质疏松股骨转子间骨折的结果进行比较分析,探讨两者之间的差异. 方法 回顾性收集48例高龄股骨转子间骨折,采用THR(THR组,24例)或MIDHS( MIDHS组,24例)治疗,经过6个月以上的随访,比较两组在手术时间、术中出血、术后引流、术后髋部的功能评分及术后并发症等方面存在的差异. 结果 与MIDHS组比较,THR组手术花费时间长,术中出血及术后引流量多.THR组不同骨质疏松程度不同,但假体松动率无明显差异.MIDHS组骨质疏松不同导致内固定松动率差异明显.术后MIDHS组和THR组内置物松动率分别为33.3％、4.1％(P＜0.05).术后6个月两组患髋功能评定无明显差异.结论 为能获得早期更多功能恢复及较少的术后并发症,对于伴骨质疏松的转子间骨折患者,如果高龄且骨质疏松不明显可考虑行MIDHS,而年龄较轻但骨质疏松明显的可考虑行THR.
目的 通過對使用全髖關節置換(total hip replacement,THR)以及微創動力髖螺釘(minimally invasive dynamic hip screw,MIDHS)治療伴有骨質疏鬆股骨轉子間骨摺的結果進行比較分析,探討兩者之間的差異. 方法 迴顧性收集48例高齡股骨轉子間骨摺,採用THR(THR組,24例)或MIDHS( MIDHS組,24例)治療,經過6箇月以上的隨訪,比較兩組在手術時間、術中齣血、術後引流、術後髖部的功能評分及術後併髮癥等方麵存在的差異. 結果 與MIDHS組比較,THR組手術花費時間長,術中齣血及術後引流量多.THR組不同骨質疏鬆程度不同,但假體鬆動率無明顯差異.MIDHS組骨質疏鬆不同導緻內固定鬆動率差異明顯.術後MIDHS組和THR組內置物鬆動率分彆為33.3％、4.1％(P＜0.05).術後6箇月兩組患髖功能評定無明顯差異.結論 為能穫得早期更多功能恢複及較少的術後併髮癥,對于伴骨質疏鬆的轉子間骨摺患者,如果高齡且骨質疏鬆不明顯可攷慮行MIDHS,而年齡較輕但骨質疏鬆明顯的可攷慮行THR.
목적 통과대사용전관관절치환(total hip replacement,THR)이급미창동력관라정(minimally invasive dynamic hip screw,MIDHS)치료반유골질소송고골전자간골절적결과진행비교분석,탐토량자지간적차이. 방법 회고성수집48례고령고골전자간골절,채용THR(THR조,24례)혹MIDHS( MIDHS조,24례)치료,경과6개월이상적수방,비교량조재수술시간、술중출혈、술후인류、술후관부적공능평분급술후병발증등방면존재적차이. 결과 여MIDHS조비교,THR조수술화비시간장,술중출혈급술후인류량다.THR조불동골질소송정도불동,단가체송동솔무명현차이.MIDHS조골질소송불동도치내고정송동솔차이명현.술후MIDHS조화THR조내치물송동솔분별위33.3％、4.1％(P＜0.05).술후6개월량조환관공능평정무명현차이.결론 위능획득조기경다공능회복급교소적술후병발증,대우반골질소송적전자간골절환자,여과고령차골질소송불명현가고필행MIDHS,이년령교경단골질소송명현적가고필행THR.
Objective To compare the outcomes of total hip replacement (THR) and minimally invasive dynamic hip screw (MIDHS) in treating osteoporotic femoral intertrochanteric fractures so as to discuss the differences of the two treatment methods. Methods A retrospective study was done on 48 elderly patients with femoral intertrochanteric fractures.All the patients were randomly treated with THR (THR group) and MIDHS internal fixation ( MIDHS group).After a follow-up of over six months,the two groups were compared concerning the operation time,intraoperative blood loss,postoperative drainage,postoperative hip function,and postoperative complications. Results THR group had longer operation time,larger volume of intraoperative bleeding and postoperative drainage as compared with the MIDHS group.The incidence of internal fixation loosening varied significantly with different degree of osteoporosis in the MIDHS group,but not in the THR group.The loosening rate of the implants in the MIDHS and THR groups was 33.3％ and 4.1％ respectively,with significant difference.Functional evaluation of hip showed no significant differences between the two groups six months postoperatively. Conclusion For achieving earlier and better functional recovery and less postoperative complications in the management of osteoporotic femoral intertrochanteric fractures,MIDHS can be considerel for the elderly patients with low degree of osteoporosis and THR for younger patients with high degree of osteoporosis.
