生物型加长柄关节置换治疗高龄股骨转子间不稳定骨折的中期疗效分析
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作者Author单位AddressE-Mail
邓闽军 DENG MIN JUN 浙江省湖州市第一人民医院骨科
浙北骨质疏松骨病防治中心
The first people'
'
s hospital of Huzhou
dmj19800528@163.com 
孙振国* sunzhenguo 浙江省湖州市第一人民医院骨科
浙北骨质疏松骨病防治中心 浙江湖州 313000
The First People&
amp
#39
&
amp
#39
s Hospital of Huzhou,
775200057@qq.com 
闵继康 minjikang 浙江省湖州市第一人民医院骨科 浙江湖州 313000  
杨红航 yanghonghang 浙江省湖州市第一人民医院骨科
浙北骨质疏松骨病防治中心
 
李恒 liheng 浙江省湖州市第一人民医院骨科 浙江湖州 313000  
期刊信息:《中国骨伤》年,第卷,第期,第-页
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中文摘要:目的:探讨生物型加长柄关节置换治疗高龄股骨转子间不稳定骨折的中期疗效。 方法:自2015年1月至2018年1月,对收治的64例高龄股骨转子间不稳定骨折患者采用手术治疗,根据手术治疗方式分为关节置换组(生物型加长柄关节置换)及内固定组(PFNA),通过分析患者的手术时间、术中失血量、并发症情况,并进行随访观察,记录患者Harris髋关节功能评分及SF-36生活质量评分等,进行临床疗效评价。 结果:所有患者均获得有效随访,时间13-39个月,平均23.4个月。关节置换组患者手术时间及出血量均多于内固定组,差异有统计学意义(P<0.05);关节置换组发生1例肌间静脉血栓及1例因摔伤导致后脱位,内固定组发生1例骨折不愈合,2例肌间静脉血栓,4例轻度压疮,2例内固定松动,差异有统计学意义(χ2=4.929,P=0.026)。关节置换组患者髋关节Harris功能评分优于内固定组,差异有统计学意义(P<0.05);关节置换组患者SF-36生活质量评分优于内固定组,差异有统计学意义(P<0.05); 结论:采用生物型加长柄关节置换治疗股骨转子间不稳定骨折,术后并发症更少,髋关节功能恢复更好,患者生活质量更高。
【关键词】生物型加长柄,关节置换,股骨转子间,不稳定骨折
 
Medium-term efficacy of bio-lengthened stem arthroplasty in the treatment of unstable intertrochanteric femoral fractures in elderly patients
ABSTRACT  Objective: To investigate the mid-term effect of biotype elongated handle joint replacement in the treatment of unstable intertrochanteric fracture of femur in the elderly. Method:From January 2015 to January 2018, 64 cases of elderly patients with unstable intertrochanteric fracture of femur undergoing surgical treatment, according to the treatment,the patients were divided into arthroplasty group(biotype elongated stipe joint replacement) and internal fixation group(PFNA). The operation time,blood loss and complications were analyzed,followed-up observation was carried out,Harris hip function score and SF-36 quality of life score were recorded for clinical evaluation. Resuts: All patients were followed up effectively,time 13-39 months,average 23.4 months.The operation time and bleeding volume in the arthroplasty group were more than those in the fixation group,and the difference was statistically significant(P<0.05). Comparison of postoperative complications, intermuscular venous thrombosis occurred in 1 case and posterior dislocation occurred in 1 case in the arthroplasty group,and in the internal fixation group,there were 1 case of nonunion of fracture,2 case of intermuscular venous thrombosis,4 cases of mild pressure ulcer and 2 cases of loosening of internal fixation, and the difference was statistically significant(χ2=4.929,P=0.026).The Harris function score of hip joint in arthroplasty group was better than that in internal fixation group, the difference was statistically significant(P<0.05). The SF-36 quality of life score in arthroplasty group was better than that in internal fixation group, the difference was statistically significant(P<0.05). Conclusion:The treatment of unstable femoral intertrochanteric fracture with biolengthened handle arthroplasty has fewer complications,better recovery of hip function and higher quality of life.
KEY WORDS  Biolengthened handle  Arthroplasty  intertrochanteric femur  unstable fracture
 
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