【摘要】：目的：通過(guò)分析54例老年股骨粗隆間骨折(intertrochanteric fracture of femur,IFF)患者的臨床資料、手術(shù)方法以及隨訪結(jié)果,總結(jié)比較解剖型髖動(dòng)力帶鎖鋼板(anatomical dynamic hip lock plate, ADHL P)和動(dòng)力髖螺釘(dynamic hip screw,DHS)治療老年股骨粗隆間骨折的有效性和安全性。方法：采取回顧性分析的方法。選取我院2012年9月-2013年12月54例老年股骨粗隆間骨折患者,其中ADHLP內(nèi)固定組28例,DHS內(nèi)固定組26例。比較分析兩組患者的術(shù)中出血量、手術(shù)時(shí)間、住院時(shí)間、下地負(fù)重時(shí)間、骨折愈合時(shí)間、術(shù)后并發(fā)癥及術(shù)后1年髖關(guān)節(jié)功能評(píng)價(jià),并用SPSS19.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果：獲隨訪患者54例,隨訪時(shí)間為13～17個(gè)月,平均14.6個(gè)月。ADHLP內(nèi)固定組比DHS內(nèi)固定組下地負(fù)重時(shí)間早、骨折愈合時(shí)間短,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)中出血量、手術(shù)時(shí)間、住院時(shí)間無(wú)明顯統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后1年髖關(guān)節(jié)功能評(píng)價(jià)ADHLP內(nèi)固定組與DHS內(nèi)固定組相比較無(wú)明顯統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后并發(fā)癥ADHLP內(nèi)固定組并發(fā)癥總發(fā)生率低于DHS組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：應(yīng)用ADHLP內(nèi)固定治療老年股骨粗隆間骨折具有下地負(fù)重時(shí)間早、骨折愈合時(shí)間短、術(shù)后并發(fā)癥發(fā)生率低的優(yōu)點(diǎn)。對(duì)于老年股骨粗隆間骨折,ADHLP內(nèi)固定比DHS內(nèi)固定具有更多的優(yōu)勢(shì),可以作為一種優(yōu)先考慮的內(nèi)固定系統(tǒng)。
[Abstract]:Objective: to analyze the clinical data, surgical methods and follow-up results of 54 elderly patients with intertrochanteric fracture of femur (intertrochanteric fracture of femur IFF). To compare the efficacy and safety of anatomical hip dynamic locking plate (anatomical dynamic hip lock plate, ADHL P) and dynamic hip screw (dynamic hip screwDHS) in the treatment of femoral intertrochanteric fractures in elderly patients. Methods: retrospective analysis was used. From September 2012 to December 2013, 54 elderly patients with intertrochanteric fracture of femur were selected, including 28 cases in ADHLP internal fixation group and 26 cases in DHS internal fixation group. The blood loss, operation time, hospitalization time, weight loading time, fracture healing time, postoperative complications and hip function evaluation were compared between the two groups. The results were analyzed by SPSS19.0 software. Results: 54 cases were followed up for 13 ~ 17 months (mean 14.6 months). ADHLP internal fixation group had earlier weight loading time and shorter fracture healing time than DHS internal fixation group. The difference was statistically significant (P0.05). The length of hospitalization was not statistically significant (P0.05). 1 year after operation, there was no significant difference in hip function evaluation between ADHLP group and DHS group (P0.05). The total incidence of complications in ADHLP group was lower than that in DHS group (P0.05). Conclusion: the treatment of intertrochanteric fracture with ADHLP has the advantages of early loading time, short healing time and low incidence of postoperative complications. ADHLP has more advantages than DHS in the treatment of intertrochanteric fractures in the elderly, and it can be regarded as a priority internal fixation system.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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