关节置换与内固定治疗老年股骨粗隆间骨折的疗效和安全性比较

田建宁

（陕西省泾阳县医院骨科，陕西 咸阳，713700）

浏览次数：79次 下载次数：313次

摘要：

目的 探讨关节置换与内固定治疗老年股骨粗隆间骨折的疗效和安全性。方法 选择2014年1月至2016年12月在我院治疗的120例老年股骨粗隆间骨折患者作为研究对象，采用随机数字表法将其分为观察组与对照组，每组60例。对照组采用内固定治疗，观察组采用关节置换治疗，比较两组的治疗效果、骨密度变化以及并发症发生情况。结果 观察组总有效率高于对照组（P<0.05）；术后半年两组骨密度评分明显升高，且观察组明显高于对照组（P<0.05）；经不同的手术治疗后，观察组并发症总发生率低于对照组（P<0.05）。结论 采用关节置换治疗老年股骨粗隆间骨折疗效确切，临床疗效显著优于内固定治疗，有利于增强患者术后骨密度，且术后并发症较少，可使患者获得较好预后。

关键词：关节置换；内固定；老年股骨粗隆间骨折

中图分类号：R687.3 文献标志码：A文章编号：2096-1413(2017)20-0066-02

Efficacy and safety comparison of joint replacement and internal fixation in treatment of senile intertrochanteric fracture
TIAN Jian-ning
(Department of Orthopaedics, Jingyang County Hospital of Shaanxi Province, Xianyang 713700, China)

ABSTRACT: Objective To investigate the efficacy and safety of joint replacement and internal fixation in treatment of senile intertrochanteric fracture. Methods One hundred and twenty cases of patients with senile intertrochanteric fracture treated in our hospital from Juanuary 2014 to December 2016 were selected as research objects, and they were divided into observation group and control group according to random number table, with 60 cases in each group. The control group was treated with internal fixation, while the observation group was treated with joint replacement. The curative effects, changes of bone density and complications of the two groups were compared. Results The total effective rate of the observation group was higher than that of the control group (P<0.05); after surgery for half a year, the scores of bone density of the two groups significantly increased, and that of the observation group was higher than that of the control group (P<0.05); after treatment with different surgery, the total incidence rate of complications of the observation group was lower than that of the control group (P<0.05). Conclusion Joint replacement in treatment of senile intertrochanteric fracture has definite efficacy, whose clinical efficacy is significantly better than that of the internal fixation. Joint replacement can strengthen postoperative bone density, has less complications and can achieve better prognosis.
KEYWORDS: joint replacement; internal fixation; senile intertrochanteric fracture

参考文献：
[1] 李奕标,蔡瑞歆,程培楷,等.人工双动股骨头置换与PFNA 内固定治疗高龄股骨粗隆间骨折[J].局解手术学杂志,2016,25(9):680-683.
[2] 安成功.内固定术与一期小粗隆完整关节置换术治疗老年股骨粗隆间骨折的疗效观察[J].中国医药导刊,2015,17(9):878-879.
[3] 张智海,刘忠厚,李娜,等.中国人骨质疏松症诊断标准专家共识(第三稿2014 版)[J].中国骨质疏松杂志,2014,20(9):1007-1010.
[4] 董建彬,王智勇,芦浩,等.内固定术与髋关节置换术治疗股骨粗隆间骨折疗效的Meta 分析[J].中国骨伤,2015,28(3):245-251.
[5] 郭新安,薛辉.防旋型股骨近端髓内钉与髋关节置换术治疗股骨粗隆间骨折临床疗效比较[J].河北医学,2017,23(1):144-147.
[6] 刘成功,戚超,张海宁,等.关节置换法与内固定法治疗老年骨质疏松合并股骨粗隆间骨折的临床对比分析[J].现代生物医学进展,2016,16(4):741-743.
[7] 费国策,许立新,张斌,等.人工关节置换和PFNA 内固定治疗老年股骨粗隆间骨折对比研究[J].陕西医学杂志,2016,45(10):1338-1339.
[8] 孙勇,张卫红.两种不同术式治疗高龄不稳定股骨粗隆间骨折的对比分析[J].世界中西医结合杂志,2015,10(1):62-64.
[9] 王炜,李富航,闫相斌.人工关节置换与内固定治疗骨质疏松性不稳定股骨粗隆间骨折对比分析[J].陕西医学杂志,2017,46(1):88-89.
[10] 曾晓波,刘示,肖思贤,等.内固定与关节置换术治疗老年股骨粗隆间骨折临床疗效比较[J].河北医药,2017,39(4):500-503,507.