DHS与ALP治疗老年股骨粗隆间骨折的比较研究
投稿时间:2015-01-15  修订日期:2015-02-05  点此下载全文
引用本文:王伟,孙卓.DHS与ALP治疗老年股骨粗隆间骨折的比较研究[J].医学研究杂志,2015,44(12):166-169
DOI: 10.11969/j.issn.1673-548X.2015.12.047
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作者单位
王伟 272072 济宁, 兖矿集团有限公司总医院骨科 
孙卓 272072 济宁, 兖矿集团有限公司总医院骨科 
中文摘要:目的分析动力髋螺钉(DHS)和股骨近端解剖锁定钢板(ALP)治疗老年股骨粗隆间骨折的临床疗效,探讨影响治疗效果的因素。方法回顾分析2010年2月~2012年5月分别采用DHS和ALP治疗并得到随访的65例老年股骨粗隆间骨折患者,对手术时间、术中出血量、卧床时间、骨折愈合时间、术后并发症和术后髋关节功能评分进行分析比较。结果所有患者均获得10~23(平均16.0)个月随访。两组手术时间、术中出血量、卧床时间及骨折愈合时间比较差异无统计学意义(P>0.05)。Sanders髋关节功能评分ALP组优于DHS组,差异有统计学意义(P<0.01)。DHS组术后出现内固定物断裂2例,螺钉拔出2例,髋内翻3例,肢体短缩2例,优良率71.9%;ALP组术后出现内固定物断裂1例,髋内翻1例,肢体短缩1例,优良率90.9%,两组比较差异有统计学意义(P<0.05)。结论应用DHS和ALP治疗老年股骨粗隆间骨折, ALP的临床疗效优于DHS。
中文关键词:股骨粗隆间骨折  动力髋螺钉  股骨近端解剖锁定钢板
 
A Comparative Study of Dynamic Hip Screw and Anatomic Proximal Femoral Locking Plate in the Treatment of Intertrochanteric Femoral Fractures in Elderly Patients.
Abstract:Objective To study the significance of the treatment of intertrochanteric hip fractures in elder patients by comparing the effects of dynamic hip screw and anatomic proximal femoral locking plate internal fixation, and discuss the influencing factors of treatment effectiveness, we also hope to to table a proposal of preventative measures. Methods The 65 elderly patients with intertrochanteric hip fractures from February 2010 to May 2012 were followed up. They were treated with two kinds of operations respectively:dynamic hip screw (DHS), anatomic proximal femoral locking plate (ALP).The data of each group were collected for statistical analysis on the following aspects:operative time, blood loss, in-bed time,clinical healing time of fractures, postoperative complications, functional outcome (Sanders traumatic hip rating scale). Results All the patients were followed up 10 to 23 months (average 16.0 months).There was no statistical difference between two groups in operative time, blood loss, in-bed time and clinical healing time of fractures(P>0.05).The difference of functional outcome between two groups were of statistical significance(P<0.01).ALP group had more satisfactory outcome. The postoperative complications in DHS group included the breakage of internal fixture in 2 cases, screw extraction in 2 cases, coxa vara in 3 cases,limb shortening in 2 cases, excellent and good rate were 71.9%. The postoperative complications in ALP group included the breakage of internal fixture in 1 case, coxa vara in 1 case,limb shortening in 1 case, excellent and good rate were 90.9%. There was statistical significance between two groups in post-operative complications(P<0.05). Conclusion Clinical effect of elderly femoral intertrochanteric fractures treated with DHS and ALP shows ALP is superior to DHS. For unstable IFF, ALP should be the first choice. The stability of the medial cortex and the posterior lateral wall of proximal femur must be reconstructed intraoperatively, and bone grafting is required. Too early weight bearing activities should be avoided after internal fixation.
keywords:Intertrochanteric hip fracture  Dynamic hip screw  Anatomic proximal femoral locking plate
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