半髋关节置换与DHS内固定治疗高龄不稳定型股骨转子间骨折的疗效比较Comparison of hemiarthroplasty and DHS fixation for the treatment of unstable intertrochanteric hip fractures in senile patients
叶伟雄;梁伟国;陈鸿辉;
摘要(Abstract):
[目的]分析比较半髋关节置换与DHS内固定治疗高龄不稳定型股骨转子间骨折的疗效,探讨治疗高龄不稳定型股骨转子间骨折的合理治疗方法。[方法]回顾性分析2002年6月~2005年10月期间接受半髋关节置换或DHS内固定治疗且具有完整资料的126例高龄股骨转子间骨折。其中半髋关节置换组53例,DHS内固定组73例;均合并有多系统内科疾病,且伴有严重骨质疏松;按改良Evens-Jensen分型,均为不稳定型骨折。比较2种治疗方法在手术时间、术中或术后输血量、术后卧床时间、术后并发症发生率及术后1年St.Michael髋关节评分等方面的指标。[结果]半髋关节置换组和DHS内固定组的平均随访时间分别为16、18个月。半髋关节置换组与DHS内固定组相比,术后卧床时间明显缩短、手术并发症发生率明显降低、术后1年关节功能评分明显增高,两者的差异具有显著性意义(P<0.05)。但两组的手术时间和输血量却无显著性差异(P>0.05)。[结论]骨水泥型半髋关节置换具有允许术后早期完全负重活动、并发症发生率低和功能恢复满意等优点,是治疗高龄不稳定型股骨转子间骨折的较合理的手术方法。
关键词(KeyWords): 半髋关节置换;DHS内固定;股骨转子间骨折;高龄患者;不稳定型骨折
基金项目(Foundation):
作者(Author): 叶伟雄;梁伟国;陈鸿辉;
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参考文献(References):
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