SL-R柄人工股骨头置换术与股骨近端防旋髓内钉治疗老年不稳定型骨质疏松性股骨粗隆间骨折的疗效比较研究

目的:探讨股骨近端防旋髓内钉、SL-R柄人工股骨头置换术两种术式治疗老年不稳定型骨质疏松性股骨粗隆间骨折的应用效果。方法:选取2015年1月-2017年6月间于河北医科大学附属秦皇岛市第一医院行手术治疗的老年不稳定型骨质疏松性股骨粗隆间骨折患者98例,以数表法将患者随机均分为对照组(n=49)和观察组(n=49)。其中对照组采用股骨近端防旋髓内钉,观察组采用SL-R柄人工股骨头置换术。比较两组患者临床各项指标、手术前后髋关节功能评分以及术后并发症发生情况。结果:观察组手术时间、术中失血量均高于对照组,但住院时间、开始负重时间则低于对照组(P0.05)。观察组术后并发症发生率为4.08%(2/49),低于对照组的18.37%(9/49)(P0.05)。术后1个月、3个月时患者髋关节各项评分相比术前均有升高,术后3个月的各项评分高于术后1个月(P0.05);观察组术后1个月、3个月各项评分均高于对照组(P0.05)。结论:在老年不稳定型骨质疏松性股骨粗隆间骨折患者治疗过程当中,采用SL-R柄人工股骨头置换术可减少住院时间,疗效确切,无严重并发症,且可改善髋关节各项功能评分。

Comparison of the Effect of SL-R Handle Artificial Femoral Head Replacement and Proximal Femoral Intramedullary Nail in the Treatment of Unstable Osteoporotic Intertrochanteric Fractures of the Femur in the Elderly

ABSTRACT Objective: To investigate the application of proximal femoral intramedullary nail and SL-R handle artificial femoral head replacement in the treatment of unstable osteoporotic intertrochanteric fractures of the femur in the elderly. Methods: 98 cases of unstable osteoporotic intertrochanteric fractures of the femur in the elderly who were treated in Qinhuangdao First Hospital affiliated to Hebei Medical University from January 2015 to June 2017 were selected, the patients were randomly divided into control group (n=49) and observation group (n=49) according to the number table method. The control group was treated with proximal femoral intramedullary nail,the observation group was treated with SL-R handle artificial femoral head replacement. The clinical indexes of the two groups,the hip function score before and after the operation and the postoperative complications were compared. Results: The operation time and blood loss in the observation group were all higher than those of the control group, but the time of hospitalization and the time of starting weight negative were lower than those of the control group (P<0.05). The incidence of postoperative complications in the observation group was 4.08% (2/49), which was lower than 18.37% (9/49) of the control group (P<0.05). The scores of hip function at 1 months and 3 months after operation were higher than that before operation,and the scores of hip function at 3 months after operation were higher than that of 1 months after operation (P<0.05). The scores of hip function at 1 months and 3 months after operation in the observation group were higher than those in the control group (P<0.05). Conclusion: In the treatment of unstable osteoporotic intertrochanteric fractures of the femur in the elderly, SL-R handle artificial femoral head replacement can reduce the time of hospitalization, the curative effect is accurate, no serious complications, and can improve the function of the hip joint score.