半髋关节置换与pfn内固定治疗高龄不稳定型股骨粗隆间骨折的疗效比较

《半髋关节置换与pfn内固定治疗高龄不稳定型股骨粗隆间骨折的疗效比较》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、半髋关节置换与PFN内固定治疗高龄不稳定型股骨粗隆间骨折的疗效比较作者：叶冬平，李锋生，梁伟国　陈鸿辉【摘要】[目的]分析比较PFN内固定与半髋关节置换治疗高龄不稳定型股骨粗隆间骨折的疗效，探讨治疗高龄不稳定型股骨粗隆间骨折的合理治疗方法。[方法]回顾性分析2005年4月-2007年4月间接受PFN内固定或半髋关节置换治疗且具有完整资料的82例高龄股骨粗隆间骨折。其中PFN内固定组46例，半髋关节置换组36例;均合并有多系统内科疾病。按改良EvensJensen分型，均为不稳定骨折。比较2种治疗方

2、法在切口长度，手术时间、术中出血量，手术输血量、术后卧床时间，内科并发症、内植物并发症、术后1年关节功能状况等方面的指标。[结果]PFN内固定组和半髋关节置换组的平均随访时间分别为16、18个月。PFN内固定治疗组与半髋关节置换组相比较，手术时间、术后卧床时间均较长，手术出血量、输血量较少，切口长度较小(P<0.05)，但内科并发症、内植物并发症、髋关节功能恢复等差异不明显(P>0.05)。[结论]半髋关节置换术和PFN内固定术均是治疗高龄患者粗隆间不稳定骨折的有效方法。【关键词】半髋关

3、节置换术;PFN内固定;股骨粗隆间骨折;高龄患者;不稳定型骨折13　　Abstract：[Objective]TodiscussareasonabletreatmentforunstableintertrochanterichipfracturesinsenilepatientsbycomparingtheeffectsofPFNfixationandhemiarthroplasty.[Method]Totally82intertrochanterichipfracturesinsenilepati

4、entswithcompleteclinicaldatawereretrospectivelyanalyzed,whoweretreatedwithhemiarthroplastyorPFNfixationfromApril2005toApril2007.Fortysixweretreatedwithhemiarthroplasty,36weretreatedwithPFNfixation.Allofthemhadmultiplemedicalcomorbidities.Accordingtom

5、odifiedEvensJensenclassification,allofthembelongedtounstablefracture.Comparisonwasmadebetweenthetwotreatedgroupsintermsofthelengthofincision,operativetime,thebloodlost,bloodtransfusionduringoraftersurgery,timeforbedrestpostoperatively,postoperativecom

6、plicationsandSt.Michaelhipscoreoneyearaftersurgery.[Result]TheaveragedurationoffollowupforPFNfixationandhemiarthroplastywere16and18monthsrespectively.Comparedwiththegroupofhemiarthroplasty,thegroupofPFNfixationexperiencedlongeroperationtime,longertime

7、forbedrestpostoperatively,lessbloodlost,lessbloodtransfusionduringoraftersurgery,shorterincisionlength,andthedifferencesbetweentwo13groupshadstatisticalsignificance(P<0.05).Whereasthedifferencesinthepostoperativeinternalmedicinecomplicationsandthepo

8、stoperativeimplantcomplications,St.Michaelhipscoreoneyearaftersurgerybetweentwogroupshadofnostatisticalsignificance(P>0.05).[Conclusion]Bothofthetwomethodsarereasonabletreatmentforunstableintertrochanterichipfracturesinsenilepatients