胡浩  王景

[摘要] 目的 探讨人工股骨头置换治疗老年不稳定型股骨转子间骨折的方法及临床价值。 方法 选择2007年10月~2012年10月我院收治不稳定型股骨转子间骨折的老年患者53例，分为人工股骨头置换组23例、动力髋部螺钉方法（DHS对照组）30例，比较两组手术及随访情况。 结果 人工股骨头置换组老年患者的手术时间、术中出血量、术后下床时间以及术后并发症发生率比对照组明显减少，Harris评分优良率显著增加，差异均具有统计学意义（P＜0.05）。结论 人工股骨头置换术能够使老年不稳定型股骨转子间骨折患者住院时间短、出血量少，功能恢复快，具有重要的临床意义，可广泛应用。

[关键词] 骨质疏松；股骨转子间骨折；人工股骨头置换

[中图分类号] R683.42   [文献标识码] B   [文章编号] 2095-0616（2014）08-158-03

Clinical effects of hemiarthroplasty in the treatment of elderly patients with unstable intertrochanteric fracture

HU Hao  WANG Jing

Wuhan City Jiangxia District First People's Hospital, Wuhan 430200, China

[Abstract] Objective To investigate the methods and its clinical value by hemiarthroplasty for treatment of elderly patients with unstable intertrochanteric fracture. Methods A total of 53 cases elderly patients with unstable intertrochanteric fractures in our hospital from October 2007 to 2012According to the different treatment methods were divided into two groups: hemiarthroplasty group with 23 cases, dynamic hip screw method (DHS control group) with 30 cases, surgery and follow-up cases were compared. Results Of hemiarthroplasty group of elderly patients operative time, blood loss, postoperative ambulation time and postoperative complication rate was significantly reduced compared with the control group, a significant increase in Harris score excellent rate, the differences were statistically significant (P＜0.05). Conclusion Treatment of hemiarthroplasty in elderly patients with unstable intertrochanteric fractures shorter hospital stay, less blood loss, faster recovery function has important clinical implications, can be widely applied .

[Key words] Osteoporosis; Intertrochanteric fracture; Hemiarthroplasty

股骨转子间骨折，系指股骨颈基底至小转子水平以上部位所发生的骨折，为老年人常见的损伤，约为髋部骨折的35％~40％[1]。转子部的血液循环极其丰富，因而骨折后不易愈合。尤其我国已进入老龄化社会，老年不稳定型股骨转子间骨折的发生率呈现逐年增高的趋势，严重影响了老年人的生活质量[2]。临床上多见的手术方法为内固定的方法，而近年来人工股骨头置换术的发展表现出较好的治疗效果[3-4]。本研究选择2007年10月~2012年10月我院收治不稳定型股骨转子间骨折的老年患者53例，比较人工股骨头置换与DHS两种手术方法来探讨人工股骨头置换术的临床价值。

1 资料与方法

1.1 一般资料

选择2007年10月~2012年10月我院收治不稳定型股骨转子间骨折的老年患者53例，年龄68~92岁，平均82.4岁；……