内固定与关节置换手术治疗骨质疏松性髋部骨折的临床效果及术后并发症的影响因素分析

目的:分析内固定与关节置换手术治疗骨质疏松性髋部骨折的临床效果及其术后并发症的影响因素。方法:将2017年4月至2018年5月因骨质疏松性髋部骨折于我院进行手术治疗的78例患者作为研究对象,参考患者自身意愿按照采取手术方案的不同将所有患者分为内固定组与关节置换组。内固定组主要采用动力髋螺钉内固定治疗;关节置换组采用全髋关节置换术治疗。对比分析两组治疗后并发症的发生情况及关节功能恢复程度。结果:关节置换组手术治疗后关节功能的恢复情况显著优于内固定组(P0.05),术后并发症发生率低于内固定组(P0.05);患者术后并发症发生的主要影响因素包括:术前存在合并症、手术时机≥2h、采用内固定手术。结论:与内固定术相比,关节置换手术治疗骨质疏松性髋部骨折患者的疗效和安全性均更高,但采用该手术治疗时需注意手术操作的规范性及手术时机。

Clinical Efficacy of Internal Fixation and Joint Replacement in the Treatment of Patients with Osteoporotic Hip Fractures and the Influencing Factors of Postoperative Complications

ABSTRACT Objective: To analyze the clinical efficacy of internal fixation and joint replacement in the treatment of patients with osteoporotic hip fractures and the influencing factors of postoperative complications. Methods: 78 patients who underwent surgical treatment in our hospital due to osteoporosis hip fracture were selected as subjects from April 2017 to May 2018. All patients were divided into the internal fixation group and the joint replacement group according to their own wishes and according to the different surgical plans. The internal fixation group was treated with dynamic hip screw. Total hip arthroplasty was performed in the arthroplasty group. The incidence of complications and the recovery of joint function were compared between two groups. Results: The recovery of joint function in the joint replacement group was significantly better than that in the internal fixation group (P<0.05), and the incidence of postoperative complications was lower than that in the internal fixation group (P<0.05). The main influencing factors of postoperative complications include: preoperative complications, operative time 2h, internal fixation. Conclusion: Compared with internal fixation, joint replacement is more effective and safer in the treatment of osteoporosis hip fracture.