髋关节置换术治疗老年患者严重粉碎移位股骨粗隆间骨折的效果

摘要

目的 分析髋关节置换术治疗严重粉碎移位的股骨粗隆间骨折的老年患者效果.方法 选取2014年6月～2016年6月南雄市人民医院骨科收治的股骨粗隆间骨折老年患者(≥60岁)94例,根据手术方式不同分为两组,接受内固定术治疗的45例患者作为对照组,接受髋关节置换术的49例患者作为试验组,比较两组患者的愈后情况(骨折愈合时间、术后关节可活动时间),以Harris评分评价总体疗效,随访期3个月内观察并记录两组患者术后并发症发生情况.结果 经治疗,两组患者的骨折均基本愈合.试验组的骨折愈合时间为(32.4±9.2)d、术后关节可活动时间为(7.3±1.6)d,2个月后Harris髋关节功能量化评分表综合评分为(93.6±2.0)分,而对照组对应的数据分别为(42.7±10.6)d、(18.5±2.7)d、(82.6±3.4)分,差异有统计学意义(P＜0.05).试验组和对照组的总有效率分别为95.9％和75.6％,试验组的临床疗效显著优于对照组,差异有统计学意义(P＜0.05).对照组和试验组患者术后并发症发生率分别为17.78％和6.12％,差异有统计学意义(P＜0.05).结论 严重粉碎移位的股骨粗隆间骨折的老年患者通过髋关节置换术治疗,骨折愈合状况更好,愈合周期缩短,且安全性较高,能有效提高患者的生活质量.%Objective To the effect of hip replacement in elderly patients with severe intertrochanteric fractures with severe comminuted displacement.Methods From June 2014 to June 2016,in Department of Orthopedics,Nanxiong People's Hospital,94 elderly patients (≥60 yeras old) with intertrochanteric fractures were selected,and they were divided into two groups according to different surgical methods,45 patients underwent internal fixation were as control group,49 patients underwent hip replacement were as test group.The prognosis (fracture healing time,postoperative joint activity time) of the two groups of patients were compared,the overall curative effect was evaluated by Harris score,the postoperative complications of the two groups during the follow-up 3 months were observed and recorded.Results Mter treatment,the fractures of the two groups were healed.In the test group,the duration of fracture healing was (32.4±9.2) d,the time of postoperative joint movement was (7.3±1.6) d,after 2 months Harris quantitative score of hip function was (93.6±2.0) scores,those in the control group were (42.7±10.6) d,(18.5±2.7) d,(82.6±3.4) scores respectively,the differences were statistically significant (P ＜ 0.05).The total effective rates of the test group and the control group were 95.9％ and 75.6％,the clinical curative effect of the test group was significantly better than that of the control group,the difference was statistically significant (P ＜ 0.05).The incidence of postoperative complications in the control group and the test group were 17.78％ and 6.12％,the difference was statistically significant (P ＜ 0.05).Conclusion After the hip replacement,middle-aged and elderly patients with severe intertrochanteric fractures with severe comminuted displacement are better healed in fracture and their healing cycle is shorter with higher safety,thus effectively improving the quality of life of patients.