摘要
目的通过临床的一些客观指标,观察与分析比较老年股骨转子间骨折内固定与人工股骨头置换术适应证和效果。方法2002年3月～2004年11月治疗老年股骨转子间骨折84例。改良Evans-Jensen分型:Ⅰ型骨折30例,Ⅱ型骨折25例,Ⅲ型骨折19例,Ⅳ型骨折7例,Ⅴ型骨折3例。年龄65～94岁,平均74.6岁。A组:人工股骨头置换术置换21例。B组:内固定63例。结果术后随访1～51个月,平均11.5个月。A组与B组的年龄、住院时间、术中出血和术中输血等比较有差异。A组:手术创伤大,手术时间短,术后卧床时间短,住院时间短,部分病人需输血,平均年龄稍大。B组:手术创伤小,手术时间长。术中出血少,不需输血,住院时间长,平均年龄小。疗效按生活自理程度分为:生活完全自理54例,部分自理23例,卧床不能自理6例,死亡1例。结论二种手术方法各有优势,只要根据不同的适应证及术者的经验,人工股骨头置换术也适用于老年股骨转子间骨折的治疗。
Objective To compare the clinical effect of hip arthroplasty and internal fixation for the treatment of intertroehanteric fracture. Methods Eighty- four patients with intertroehanteric fracture were treated from March 2002 to November 2004. According to Evans- Jensen classification, there were 30 cases of type Ⅰ, 25 cases of type Ⅱ, 19 cases of type Ⅲ, 7 cases of typeⅣ and 3 cases of type V. Their average age was 74.6 （65-94）. In Group A, 21 cases were treated with hip arthroplasty. In Group B, 63 cases were treated with internal fixation. Results The patients were followed up for 1 month to 51 months, 11.5 months on the average. There were shorter operation time but more injury, shorter staying at hospital and less amount of blood transfusion in Group A. In Group B, there were less injury but longer operation time; less blood loss and no blood transfusion. Conclusion Both methods have advantages. Hip arthroplasty can also be used to the treatment of intertrochanteric fracture in elderly patients.
出处
《中国骨与关节损伤杂志》
2005年第10期661-663,共3页
Chinese Journal of Bone and Joint Injury
