动力髋螺钉及股骨近端锁定加压钢板治疗老年粗隆间粉碎性骨折疗效比较.docVIP

动力髋螺钉及股骨近端锁定加压钢板治疗老年粗隆间粉碎性骨折疗效比较 　　[摘要] 目的 研究探讨动力髋螺钉和股骨近端锁定加压钢板治疗老年股骨粗隆间粉碎性骨折的临床疗效。方法 随机选取于该院2015年1月―2016年1月骨科诊治的老年股骨粗隆间粉碎性骨折行手术治疗的患者82例，按照随机数表法将研究对象随机分为两组，对照组患者的手术方式为动力髋螺钉，观察组患者的手术方式为股骨近端锁定加压钢板，回顾性分析入选患者的所有完整临床资料及随访资料，统计、观察与比较两组患者手术时间、术中出血量、术后引流量、骨折愈合所需时间等指标，术后切口感染、内固定松动断裂等并发症发生情况，术后髋关节功能恢复情况。结果 观察组术后并发症发生率及髋关节功能恢复优良率分别为12.20%、92.68%，对照组分别为9.76%、95.12%，组间差异无统计学意义（P0.05）。结论 在老年股骨粗隆间粉碎性骨折治疗中，临床上尚需依据患者的骨折严重程度或类型、自身身体状况、经济状况等因素综合考虑制定诊疗方案 [关键词] 股骨粗隆间粉碎性骨折；股骨近端锁定加压钢板；动力髋螺钉；临床疗效 [中图分类号] R683 [文献标识码] A [文章编号] 1674-0742（2017）03（b）-0073-03 [Abstract] Objective To research and analyze the clinical curative effect of dynamic hip screw and proximate femur locking compression plate in treatment of senile femoral intertrochanteric thrypsis. Methods 82 cases of senile patients with femoral intertrochanteric thrypsis diagnosed in our hospital from January 2015 to January 2016 were randomly selected and randomly divided into two groups， the control group were treated with hip screw， while the observation group were treated with proximate femur locking compression plate， and all the clinical data and follow-up data of patients were retrospectively analyzed， and the operation time， intraoperative bleeding amount， postoperative drainage amount and fracture healing time， occurrence of complications such as postoperative incision infection and internal fixation loosening or breakage of the two groups were observed and compared. Results The differences in the incidence rate of postoperative complications and excellent and good rate of hip joint functional recovery between the observation group and the control group had no statistical significance （12.20%， 92.68% vs 9.76%， 95.12%）（P0.05），组间具有可比性。 　　1.2 治疗方法 1.2.1 手术方法 入选患者均采用硬膜外麻醉，取平卧位，充分暴露骨折端后清理骨折端软组织，后进行骨折复位 1.2.2 内固定方法 股骨粗隆间粉碎性骨折手术切开复位后，选择相应的内固定方法，即DHS和PF-LCP。DHS内固定： 术中暴露股骨近端外侧面、股骨大小转子后，从大粗隆下方作为进针点，从股骨外侧沿股骨头颈方向进克氏针，进针成功后沿导针扩孔进入螺钉并保持固定；PF-LCP内固定：术中暴露股骨近端外侧面、股骨大小转子后，将股骨近端锁定钢板贴附于股骨外侧插入骨折端施行内固定 1.2.3 术后处理 术后均予以常规术后处理，并嘱患者在医