半髋关节置换治疗老年不稳定股骨转子间骨折的临床应用

目的探讨老年不稳定股骨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的65例老年不稳定股骨转子间骨折患者为研究对象,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)m L,髓内钉固定组术中出血量(419.6±40.2)m L,两组术中出血量比较差异无统计学意义(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30.3%,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。

Clinical Application of Hemiarthroplasty in Treating Unstable Intertrochanteric Fracture among Elderly Patients

Objective To evaluate the clinical effect of hemiarthroplasty on elderly patients with unsta- ble intertrochanteric fracture. Methods A total of 65 elderly patients with unstable intertrochanteric fracture admitted in Anyue People＇s Hospital from Jan. 2010 to Apr. 2012 were selected and randomly divided into femoral intramedullary nail insertion group （ n = 33 ） and hemiarthroplasty groups（ n = 32 ）, patients in hemiarthroplasty group were treated with hemiarthroplasty and patients in femoral intramedullary nail insertion group were treated with proximal femoral intramedullary nail insertion. The operative time,intraoperative vol- ume of blood loss, postoperative complications and function of hip joint of the two groups were compared. Results Operative time was （94.9 ±14.6 ） rain in hemiarthroplasty groups and （ 106.2±18.7 ） rain in femoral intramedullary nail insertion group, operative time was shorter in hemiarthreplasty group than in femoral intramedullary nail insertion group（ P 〈 0.05 ） ;intraoperative volume of blood loss was （436.4±37.6 ） mL in hemiarthreplasty group and was （419.6±40.2） mL in femoral intramedullary nail insertion group,the difference was statistically significant（ P 〉 0.05 ） ; incidence rate of medical complications was 9.4% in hemiarthroplasty group and was 21.1% in femoral intramedullary nail insertion group,incidence rate of med- ical complications was lower in hemiarthroplasty group than in femoral intramedullary nail insertion group （ P 〈 0. 05） ; 12 months after operations, function grading of hip joint of hemiarthroplasty groups was superior to femoral intramedullary nail insertion group （ P 〈 0.05 ）. Conclusion Hemiarthroplasty has good clinical curative effect on elderly patients with unstable inertroehanterie fracture, as it could improve the recovery of joint function and decrease the incidence of complications.