人工股骨头置换与动力髋螺钉内固定用于老年股骨头转子间骨折治疗的疗效比较

目的：比较人工股骨头置换术与动力髋螺钉内固定治疗老年股骨头转子间骨折的临床疗效。方法：选择我院74例老年股骨头转子间骨折患者作为观察对象，随机分为A组（人工股骨头置换术）和B组（动力髋螺钉内固定术），每组37例。比较两组患者的手术时间、术中出血量、术后卧床时间、术后Harris评分及术后并发症和死亡率。结果：手术时间和术后卧床时间A组明显短于B组（P〈0．05），A组术中出血量较B组明显减少，差异显著（P〈0．05）。术后1、3个月Harris评分A组均高于B组（P〈0．05）；术后6个月Harris评分两组无明显差异（P〉0．05）。结论：与动力髋螺钉内固定术相比，人工股骨头置换术术后可更早负重、恢复好，而且并发症少，是较为理想的治疗老年股骨头转子间骨折的治疗方法。

Comparison on the Curative Effect of Artificial Femoral Head Replacement and Dynamic Hip Screw Internal Fixation for Senile Femoral Head Fracture

Objective： To compare the curative effect of artificial femoral head replacement and dynamic hip screw internal fixa- tion for senile femoral head fracture. Methods： 74 elderly patients with femoral intertrochanteric fracture were selected as study objects and were randomly divided into group A （artificial femoral head replacement） and group B （dynamic hip screw internal fixation）, 37 cas- es in each group. Operation time, operation bleeding, postoperative bed time, postoperative Harris score and postoperative complications and mortality in two groups of patients were compared. Results： Operation time and postoperative recovery time in group A were signifi- cantly shorter than those in group B （P〈0.05）, bleeding in group A decreased obviously compared with group B, the difference was sig- nificant （P〈0.05）. Harris scores after 1, 3 months of group A were higher than that of group B （P〈0.05）; 6 months after surgery, Harris score in two groups had no significant difference （P〉0.05）. Conclusion： Compared with dynamic hip screw internal fixation, patients after underwent artificial femoral head replacement have earlier weight-beating, recovery, and less complications, thus artificial femoral head replacement is the ideal treatment of senile femoral intertrochanteric fracture.