中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2014年
20期
15-17,20
,共4页
老年股骨粗隆间骨折%动力髋螺钉%股骨近端防旋髓内钉%人工关节置换
老年股骨粗隆間骨摺%動力髖螺釘%股骨近耑防鏇髓內釘%人工關節置換
노년고골조륭간골절%동력관라정%고골근단방선수내정%인공관절치환
Elderly intertrochanteric fracture%Dynamic hip screw%Proximal femoral nail anti-rotation%Artificial joint replacement
目的:比较动力髋螺钉、股骨近端防旋髓内钉及人工关节置换治疗老年股骨粗隆间骨折的临床疗效。方法选取2007年1月~2013年1月我院收治的64例老年股骨粗隆间骨折患者,其中24例行PFNA内固定(PFNA组),20例行DHS内固定(DHS组),20例行人工关节置换(FHR 组)。比较三组的术中出血量、手术时间、术后下床活动时间、住院时间及术后髋关节功能的优良率、并发症。结果 PFNA组的术中出血量最少(121.8±11.3)mL、手术时间最短(52.1±13.6)min,分别与DHS组、FHR组比较差异显著(P<0.05)。 FHR组患者术后下床活动时间最快(12.4±3.2)d、住院时间最短(7.2±1.5)d,与PFNA组、DHS组比较差异有统计学意义(P<0.05)。 FHR组患者术后髋关节功能优良率达100.0%,明显高于PFNA组、DHS组(χ2=6.341、5.873,P<0.05)。 PFNA组患者术后并发症发生率最低(16.7%),明显低于DHS组、FHR 组(χ2=11.653、8.325,P<0.05)。结论动力髋螺钉、股骨近端防旋髓内钉及人工关节置换治疗老年股骨粗隆间骨折各具有优缺点。
目的:比較動力髖螺釘、股骨近耑防鏇髓內釘及人工關節置換治療老年股骨粗隆間骨摺的臨床療效。方法選取2007年1月~2013年1月我院收治的64例老年股骨粗隆間骨摺患者,其中24例行PFNA內固定(PFNA組),20例行DHS內固定(DHS組),20例行人工關節置換(FHR 組)。比較三組的術中齣血量、手術時間、術後下床活動時間、住院時間及術後髖關節功能的優良率、併髮癥。結果 PFNA組的術中齣血量最少(121.8±11.3)mL、手術時間最短(52.1±13.6)min,分彆與DHS組、FHR組比較差異顯著(P<0.05)。 FHR組患者術後下床活動時間最快(12.4±3.2)d、住院時間最短(7.2±1.5)d,與PFNA組、DHS組比較差異有統計學意義(P<0.05)。 FHR組患者術後髖關節功能優良率達100.0%,明顯高于PFNA組、DHS組(χ2=6.341、5.873,P<0.05)。 PFNA組患者術後併髮癥髮生率最低(16.7%),明顯低于DHS組、FHR 組(χ2=11.653、8.325,P<0.05)。結論動力髖螺釘、股骨近耑防鏇髓內釘及人工關節置換治療老年股骨粗隆間骨摺各具有優缺點。
목적:비교동력관라정、고골근단방선수내정급인공관절치환치료노년고골조륭간골절적림상료효。방법선취2007년1월~2013년1월아원수치적64례노년고골조륭간골절환자,기중24례행PFNA내고정(PFNA조),20례행DHS내고정(DHS조),20례행인공관절치환(FHR 조)。비교삼조적술중출혈량、수술시간、술후하상활동시간、주원시간급술후관관절공능적우량솔、병발증。결과 PFNA조적술중출혈량최소(121.8±11.3)mL、수술시간최단(52.1±13.6)min,분별여DHS조、FHR조비교차이현저(P<0.05)。 FHR조환자술후하상활동시간최쾌(12.4±3.2)d、주원시간최단(7.2±1.5)d,여PFNA조、DHS조비교차이유통계학의의(P<0.05)。 FHR조환자술후관관절공능우량솔체100.0%,명현고우PFNA조、DHS조(χ2=6.341、5.873,P<0.05)。 PFNA조환자술후병발증발생솔최저(16.7%),명현저우DHS조、FHR 조(χ2=11.653、8.325,P<0.05)。결론동력관라정、고골근단방선수내정급인공관절치환치료노년고골조륭간골절각구유우결점。
Objective To compare the efficacy of DHS,PFNA,FHR in treatment of elderly intertrochanteric fractures. Methods A total of 64 cases elderly patients with intertrochanteric fractures from January 2007 to January 2013 in our hospital, in which 24 cases treated with PFNA fixation (PFNA group), 20 cases treated with fixed routine DHS(DHS group), 20 cases treated with routine arthroplasty(FHR group). the excellent rate, blood loss, operative time, postoper-ative ambulation time, hospital stay and postoperative hip function and complications were compared. Results The blood loss was minimal in PFNA group (121.8±11.3)mL, operation time(52.1±13.6)min was the shortest, respectively, compared with the DHS group, FHR group(P<0.05). FHR group postoperative ambulation fastest time(12.4±3.2)d, the shortest length of stay(7.2±1.5)d, compared with PFNA group, DHS group (P<0.05). Postoperative hip function FHR group was 100.0%, was significantly higher than the PFNA group, DHS group(χ2=6.341, 5.873, P<0.05). PFNA group of patients with the lowest incidence of postoperative complications (16.7%), was significantly lower than the DHS group, FHR group(χ2=11.653, 8.325, P<0.05). Conclusion Dynamic hip screw and proximal femoral nail anti-rotation and artificial joint replacement in treatment of senile intertrochanteric fractures each have advantages and disadvan-tages.