骨水泥型半髋关节置换治疗高龄股骨粗隆间骨折72例.pdf

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1、·．第26卷第2期菏泽医学专科学校学报V0L．26N0．22014正JOURNALOFHEZEMEDICALCOLLEGE2014DOI：10．39690．issn．1008—4118．2014．02．17骨水泥型半髋关节置换治疗高龄股骨粗隆间骨折72例赵弟金(牡丹区高庄镇中心卫生院，山东菏泽274000)摘要：目的探讨三种不同的手术方法治疗股骨粗隆间骨折的疗效。方法选择股骨粗隆间骨折72例，随机分为三组，骨水泥型半髋关节置换组、动力髋部螺钉组、股骨近端髓内钉组，观察术后早期下床活动时间、功能恢复程度、并发症等有何不同。结果骨水泥型半髋关节置换组优势明显，与动力髋部螺钉组和股骨近端髓内钉

2、组相比，A组手术后3～5天内可以床下活动，动力髋部螺钉组和股骨近端髓内钉组要以X光片达到临床愈合标准才可以下床。术后两周及术后1个月骨水泥型半髋关节置换组分别与DHS手术、PFN手术组比较／x=10．8284；9．3106。P均<0．01，有高度显著性差异。动力髋部螺钉不同时段Harris髋关节功能评分P<0．05，有显著性差异。术后DHS手术组感染l例，坠积性肺炎DHS手术组l例，PFN手术组l例；褥疮骨水泥型半髋关节置换组1例，DHS手术组3例，PFN手术组1例。结论骨水泥型半髋关节置换治疗高龄股骨粗隆间骨折明显优于PFN及DHS两组，值得推广。关键词：老年人；骨；损伤；股骨粗隆间骨

3、折／治疗；骨水泥半髋关节置换／治疗应用中图分类号：R683．42文献标识码：A文章编号：1008—4118(2014)02—0041—0372CasesofIntertrochantericFractureintheOldTreatedbyBoneCementHalfHipReplacementZhaoDijin(TheHealthyCenterofGaozhuangCounty，Heze274000，ShandongJAbstract：ObjectiveTocomparethreedifferentsurgicalmethodsofcurativeeffectforthetreatme

4、ntofintertro—chantericfracture．Methods72casesoffemoralintertrochantericfracturewererandomlydividedintothreegroups，thebonecementtypehalfhipreplacementgroup，dynamichipscrewgroup，andproximalfemoralintramedullarynailinggroup．Observedthedifierencesoftheearlypostoperativeambulationtime，degreeoffunction

5、alrecoveryandcomplica—tions．ResultsThebonecementtypehalfhipreplacementgroupofobviousadvantages．Comparedwithdynamichipscrewandproximalfemoralintramedullarynailinggroup，thepatientsofgroupAcandoambulationin3to5daysafterthesurgery，dynamichipscrewandproximalfemoralintramedullarynailinggrouptoX—raysrea

6、chthestandardofclinicalhealingcangetoutofbed．After2weeksand1monthafterbonecementtypehalfhipreplacementgrouprespectivelywithdynamichipscrewandproximalfemoralintramedullarynailinggroupcompare肛=10．8284；9．3106．P<0．0l，therearehigh—lysignificantdifference．DifferenttimeintervalsofthedynamichipscrewHarri

7、shipfunctionscore(P<0．05)．Therearesig—nificantdifferences．Postoperativedynamichipscrewgroup1casesofinfection，hypostaticpneumoniagroupdynamichipscrewin1case，proximalfemoralintramedullarynailinggroup1case；Bedsoreboneceme