半髋关节置换治疗高龄老年不稳定转子间骨折的临床应用

摘要

目的：探讨高龄老年不稳定转子间骨折患者采用半髋关节置换治疗的临床效果。方法选择2010年1月至2012年4月安岳县人民医院骨科收治65例高龄老年不稳定转子间骨折患者,按随机数字表法分为半髋关节置换组(n=32)及髓内钉固定组(n=33),半髋关节置换组采用半髋关节置换治疗,髓内钉固定组采用股骨近端髓内钉固定治疗,比较两组患者的手术时间、术中出血量、术后内科并发症发生情况及术后髋关节功能。结果半髋关节置换组手术时间为(94.9±14.6) min,髓内钉固定组手术时间为(106.2±18.7) min,半髋关节置换组手术时间短于髓内钉固定组( P<0.05),半髋关节置换组术中出血量为(436.4±37.6) mL,髓内钉固定组术中出血量(419.6±40.2) mL,两组术中出血量的差异无统计学意义(P>0.05)。半髋关节置换组内科并发症发生率为9.4%,髓内钉固定组内科并发症发生率为21.1%,半髋关节置换组内科并发症发生率低于髓内钉固定组(P<0.05)。术后12个月半髋关节置换组髋关节功能分级优于髓内钉固定组(P<0.05)。结论半髋关节置换治疗老年不稳定转子间骨折具有较好的临床疗效,能够促进术后关节功能恢复,减少并发症的发生。%Objective To evaluation the clinical effect of hemiarthroplasty on unstable intertrochanteric fracture in eld patients. Methods 65 cases of eld patients with unstable intertrochanteric fracture were se-lected and randomzed into femoral intramedullary nail groups(n=33) and hemiarthroplasty groups(n=32) ,patients in hemiarthroplasty groups taken hemiarthroplasty and patients in femoral intramedullary nail groups taken proximal femoral intramedullary nail, operative time, volume of blood loss,medicine complications and function of hip joint were contraseted between control groups and therapy groups. Results Operative time was (94. 9 ± 14. 6) min in hemiarthroplasty groups and was (106. 2 ± 18. 7) min in femoral intramedullary nail groups ,Operative time was shorter in hemiarthroplasty groups than in femoral intramedullary nail groups (P<0.05), Volume of blood loss was (436.4 ±37.6) ml in hemiarthroplasty groups and was (419.6 ± 40. 2) ml in femoral intramedullary nail groupsm, Volume of blood loss was identical in hemiarthroplasty groups and femoral intramedullary nail groups (P>0. 05), incidence rate of medical complications was 9. 4% in hemiarthroplasty groups and was 21. 1% in femoral intramedullary nail groupsm, incidence rate of medical complications was lower in hemiarthroplasty groups than in femoral intramedullary nail groups ( P<0. 05),at 12 months after operations, grade of hip joint functions was prevant in therapy groups to in control groups(P<0. 05). Conclusions Hemiarthroplasty had good clinical curative effect on unstable intertro-chanteric fracture in eld patients,could improve recovery of joint function and decrease complications.