髓内钉InterTAN和人工股骨头置换治疗老年不稳定股骨粗隆间骨折

摘要

Objective To compare the outcomes of treating unstable intertrochanteric fractures with InterTAN and artificial thigh bone arthroplasty in the elderly.Methods Of 35 elderly patients with unstable intertrochanteric fractures, 17 patients were treated with InterTAN, while 18 patients were treated with artificial thigh bone arthroplasty.Operative data, time for bed rest postoperatively, union time and hip function scores were recorded and compared.Results The length of incision,operative time, blood loss of InterTAN group were better than those of arthroplasty group(P＜0.05).The time for bed rest postoperatively of InterTAN group was longer(P＜0.05), while there was no significant difference in union time between two groups(P＞0.05).There was no significant difference in Harris score at the last follow-up between two groups(P＞0.05).One patient in arthroplasty group had a subsidence of replaced prosthesis.Conclusion InterTAN is rationally designed and particularly suitable for elder osteoporosis patients with unstable intertrochanteric femoral fractures.Artificial femoral head replacement could be choosen with strict surgical indications.%目的 比较InterTAN和人工股骨头置换治疗老年不稳定股骨粗隆间骨折的疗效.方法 35例老年不稳定股骨粗隆间骨折患者,17例用InterTAN治疗(InterTAN组),18例用骨水泥人工股骨头置换治疗(置换组).对两组患者手术资料、术后卧床时间、骨折愈合时间及髋关节功能评分等数据,进行随访分析.结果 InterTAN组在切口长度、手术时间、术中出血量均优于置换组(P<0.05),术后卧床时间InterTAN组稍长(P<0.05),但骨折愈合时间无显著差异(P>0.05).两组术后末次随访Harris评分无显著差异(P>0.05),置换组1例出现假体下沉.结论 InterTAN设计合理,尤其适用于骨质疏松老年不稳定的股骨粗隆间骨折.人工股骨头置换可以考虑,但应严格把握手术指征.