Objective To investigate the therapeutic effects and safety of internal fixation and replacement arthroplasty on fracture of femurs haft in elderly patients .Methods Three hundred elderly patients with fracture of femurs haft who were treated in our hospital from January 2011 to March 2015 were divided into replacement arthroplasty group and internal fixation group , moreover , replacement arthroplasty group was redivided into total hip replacement and half hip replacement group,and internal fixation group was redivided into DHS subgroup and PFNA subgroup .The generral conditions of patients, operation time,bleeding volume during operation ,lying in bed time,postoperative full weight-bearing time, Harris hip scoring before and after operation and during follow -up,Oswestry disability index ( ODI ) and incidence rates of postoperative complications were observed and compared among groups .Results There were no significant differences in gender,age,complicatins between two groups ( P <0.05).There was no significant difference in operation time among the four subgroups ( P >0.05).However there were significant differences in bleeding volume during operation ,lying in bed time,postoperative full weight-bearing time among the four subgroups ( P <0.05).There were significant differences in ODI and Harris scores between replacement arthroplasty group and internal fixation group ( P <0.05).Moreover the incidence condition of postoperative complications in replacement arthroplasty group was superior to that in internal fixation group ( P <0.05).Conclusion the replacement arthroplasty in treatment of fracture of femurs haft in elderly patients can effectively reduce lying in bed time and postoperative full weight-bearing time, and can decrease incidence rate of complicatins , with quicker joint function recovery ,therefor,which is an effective operation mode to treat fracture of femurs haft in elderly patients , so, it is suggested to use the treatment way as much as possible in clinical practice .%目的 探讨内固定治疗与关节置换术对老年股骨粗隆间骨折的临床疗效及安全性.方法 选取股骨粗隆间骨折患者300例,采用回顾性研究方法,分为置换组及内固定组,置换组中又分为全髋关节置换术亚组和半髋关节置换术亚组,内固定组又分为DHS内固定亚组和PFNA内固定亚组.比较分析2组病例一般情况、患者手术时间、术中出血量、卧床时间、术后完全负重时间,手术前后随访期间髋关节Harris评分、Oswestry功能障碍指数(ODI)及术后并发症发生情况.结果 2组性别比、年龄、合并症等一般资料差异无统计学意义(P>0.05).4亚组手术时间比较,差异无统计学意义(P>0.05).4亚组组间比较术中输血量、卧床时间、完全负重时间差异有统计学意义(P<0.05),置换组与内固定组Oswestry功能障碍指数(ODI)、Harris评分比较,差异有统计学意义(P<0.05),术后并发症发生情况比较,置换组明显优于内固定组(P<0.05).结论 老年股骨粗隆间骨折,应用关节置换术能有效减少卧床时间和完全负重时间,并发症发生率低,同时关节功能恢复快,是有效治疗老年股骨粗隆间骨折的有效术式,建议临床于确切指征下尽量用于首选治疗方式.
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