CAJ | 학술논문

目的：探讨高龄患者股骨粗隆间骨折的手术选择及其疗效分析。方法回顾性分析2008年至2013年于我院手术治疗的84例老年人股骨粗隆间骨折患者，其中 dHs 组23例，Pfna 组47例，人工股骨头置换14例。结果 Pfna组及人工股骨头置换组手术时间、出血量、术后下地时间及 Harris 评分与 dHs 组差异有统计学意义（P <0.05）。Pfna 组与人工股骨头置换组手术时间、出血量、Harris 评分差异无统计学意义（P >0.05），两组之间术后下地活动时间差异有统计学意义（P <0.05）。术后并发症比较：Pfna 组及人工股骨头置换组与 dHs 组差异有统计学意义（P<0.05）。Pfna 组及人工股骨头置换组差异无统计学意义（P >0.05）。结论对老年人股骨粗隆间骨折，应当根据不同的骨折类型，充分考虑患者个体因素，选择不同的手术方式。对于不稳定型粗隆间骨折，Pfna 治疗效果显著，合并严重骨质疏松或高龄患者，采用人工股骨头置换术，也不失为一种疗效满意的治疗方法。
목적：탐토고령환자고골조륭간골절적수술선택급기료효분석。방법회고성분석2008년지2013년우아원수술치료적84례노년인고골조륭간골절환자，기중 dHs 조23례，Pfna 조47례，인공고골두치환14례。결과 Pfna조급인공고골두치환조수술시간、출혈량、술후하지시간급 Harris 평분여 dHs 조차이유통계학의의（P <0.05）。Pfna 조여인공고골두치환조수술시간、출혈량、Harris 평분차이무통계학의의（P >0.05），량조지간술후하지활동시간차이유통계학의의（P <0.05）。술후병발증비교：Pfna 조급인공고골두치환조여 dHs 조차이유통계학의의（P<0.05）。Pfna 조급인공고골두치환조차이무통계학의의（P >0.05）。결론대노년인고골조륭간골절，응당근거불동적골절류형，충분고필환자개체인소，선택불동적수술방식。대우불은정형조륭간골절，Pfna 치료효과현저，합병엄중골질소송혹고령환자，채용인공고골두치환술，야불실위일충료효만의적치료방법。
Objective to discuss the therapeutic choice and effect of different methods in the treatment of advanced olders,intertrochanteric femur fracture.Methods retospective analysis the 84 old patients with intertrochanteric femur fracture,23 of which were fixed with DHS, 47 fixed with PFNA and 14 fixed with articial femoral head replacement.Results Pfna,articial femoral head replacement have the differences of mean operation time,blood loss, bed stay duration and Harris score ,be statistical significail(P <0.05), compared with dHs.Between Pfna and articial femoral head replacement, mean operation time,blood loss and Harris score have no differences(P >0.05),but be different in bed stay duration.the campare about postoperative complications, Pfna and articial femoral head replacement are different from dHs(P <0.05),no difference between them(P >0.05).Conclusion different patients are appropriated for the different treatments of olders, intertrochanteric femur fracture.for the unstable fractures,Pfna have a remarkbale effect.When patients suffer from osteoprosis, articial femoral head replacement will be the best therapeutic choice.