【作者】 赵斌；

【导师】 毕荣修；

【作者基本信息】 山东中医药大学 ， 中医骨伤科学， 2010， 硕士

【摘要】 目的：通过人工股骨头置换与切开复位内固定治疗高龄不稳定股骨粗隆间骨折的疗效对比,探讨人工股骨头置换术治疗高龄不稳定股骨粗隆间骨折的适应症及方法。方法：本研究将自山东中医药大学附属医院骨科病房2003年2月至2009年6月收治的高龄不稳定股骨粗隆间骨折病例中选出的符合本研究标准的病例85例,分为切开复位内固定组(59例)与人工股骨头置换组(26例)两组,通过病历回顾和术后随访,对两组的年龄、术前Evans分型、术前主要合并病、手术时间、术中出血量、术后并发症、住院时间、下地时间、内固定或假体的松动(失效)率、下地后1月及半年的Harris评分进行对比。结果：人工股骨头置换组下地时间早,可以明显降低术后下肢深静脉血栓形成的发生率,下地1月后患髋Harris评分在均数及优良率方面优于切开复位内固定组,下地半年后Harris功能评分在均数方面与切开复位内固定组无差别,但优良率达到92.3%明显优于切开复位内固定组。结论：人工股骨头置换术可大大减少卧床时间,减少术后卧床并发症的发生,可使患髋在短期内恢复至伤前水平,因此人工股骨头置换术是治疗高龄不稳定股骨粗隆间骨折的合理选择。更多还原

【Abstract】 Objective:To study the indications and surgical procedure of hemiarthroplasty for elderly patients with unstable intertrochanteric femoral fractures. Through Comparative efficacy of hemiarthroplasty and fixation for elderly patients with unstable intertrochan-teric femoral fractures. Methods:In this study,85 cases of elderly patients with unstable intertrochanteric femoral fractures were chose from Affiliated Hospital of Shandong University of TCM orthopedics ward from February 2003 to June 2009 in line with the standard of this study,85 cases were divided into the fixation group (59 cases) and hemiarthroplasty group (26 cases), through chart review and postoperative follow-up, compared two groups in age, preoperative Evans classification, the main incidence of preoperative, operative time, blood loss, hospitalization time, Shimoji time, postoperative complications, internal fixation or prosthetic loosening (failure) rate, Harris score of 1 month and six month after Shimoji.Result:Hemiarthroplasty group earlier than fixation group in shimoji time, can significantly reduce the incidence of postoperative deep venous thrombosis. Harris score of 1 month after Shimoji in both the number and excellent rate is superior to internal fixation group, Harris score of six month after Shimoji in the number is non-discrimination with the internal fixation group, but the excellent rate of 92.3% is better than internal fixation group. Conclusion:Hemiarthroplasty can significantly reduce the bed time, reduce the incidence of postoperative complications in bed suffering, Short-term restored to pre-injury level in ipsilateral hip joint. So hemiarthroplasty is the reasonable choice in treatment of elderly patients with unstable intertrochanteric femoral fractures.更多还原