人工股骨头置换及DHS内固定对高龄股骨粗隆间粉碎性骨折治疗.docVIP

人工股骨头置换及DHS内固定对高龄股骨粗隆间粉碎性骨折治疗[摘要] 目的 比较人工股骨头置换术与DHS内固定术治疗高龄患者粉碎性股骨粗隆间骨折的临床疗效。方法 2006年8月～2007年8月解放军第一七五医院骨科收治高龄股骨粗隆间粉碎性骨折患者120例。按Evans分型，Ⅲ型58 例，Ⅳ型62例。所有病例采用完全随机法分为人工股骨头置换组与DHS内固定组各60例。结果 所有病例平均随访时间1.5年。DHS内固定组有6例手术失败，重新用人工股骨头置换术治疗，其余均一期治愈；5例发生肺部感染的并发症。人工股骨头置换术患者术后仅有2例并发肺部感染，骨折均一期治愈。两组患者术后平均开始负重时间、住院天数、治愈率、术后并发症具有统计学差异（P＜0.05或0.001）。结论人工股骨头置换术治疗高龄股骨粗隆间粉碎性骨折患者的疗效优于DHS。 [关键词] 高龄； 不稳定性粗隆间骨折； 人工股骨头置换术； DHS [中图分类号] R683.42 [文献标识码] A [文章编号] 1673-9701（2009）13-13-03 DHS and Artificial Femoral Head Replacement for Intertrochanteric Fractures in Elderly Patients PENG Mingdong1 DING Zhenqi2 1.Medical College of Nanchang University，Nanchang 330000；2.Dept of Orthopaedics of The 175th Hospital of PLA，Fujian 363000 [Abstract] ObjectiveTo compare the effects of artificial femoral head replacement and DHS for comminuted intertrochanteric fractures in the elderly. Methods120 patients with comminuted intertrochanteric fractures（included Evans Ⅲ type in 63 cases and Ⅳ type in 57 cases） in the elderly（average age of（78.4±6.7）years）was conducted from August 2006 to August 2008 in our department. 65 patients were male and 55 female. All patients were divided averagely into two groups by completely randomized，60 were treaded with DHS and other half with artificial femoral head replacement. ResultsAll were followed-up average 15 months. six cases of DHS group failed and then dealed with artificial femoral head replacement，and five had postoperative pulmonary infection. Only two case had postoperative pulmonary infection in prosthetic replacement group. The diffferences in postoperative complications，cure rate，hospital stays，begin weight-bearing time between the two groups were of statistical significance（P＜0.05/0.001）. ConclusionThe effect of Artificial femoral head replacement for the management of comminuted intertrochanteric fractures in the elderly is better than that of DHS. [Key Words]Elderly； Ustable intertrochanteric fractures； Artificial femoral head replacement；