人工髋关节置换术与股骨近端髓内钉内固定术治疗老年股骨粗隆间骨折的效果对比OA

Objective:To analyze the clinical application of artificial hip replacement and proximal femoral intramedullary nail fixation in elderly patients with intertrochanteric fractures of the femur,and compare their efficacy,impact on patient recovery,and safety.Methods:A total of 70 elderly patients with intertrochanteric fracture of femur who underwent surgical treatment in the Department of Surgery of Yancheng Dafeng District Second People's Hospital were selected as the study objects,the research period is from August 2023 to April 2024,they were randomly divided into a reference group and a study group using a random number table method,with 35 patients in each group.The reference group underwent proximal femoral intramedullary nail fixation surgery,while the study group underwent artificial hip replacement surgery.Hip joint function,bone density,perioperative related indicators,pain degree,quality of life,occurrence of complications were compared between both groups.Results:At 1,3 and 6 months after operation,the Harris Hip Function Scale scores of the study group were(51.36±1.69)points,(70.72±2.34)points and(88.83±3.48)points,respectively,which were higher than(48.72±1.46)points,(67.55±2.07)points and(83.45±3.10)points of the control group;the bone mineral density of the study group were(1.48±0.37)g/cm2,(1.59±0.44)g/cm2 and(1.75±0.58)g/cm2,respectively,which were higher than(1.30±0.12)g/cm2,(1.41±0.29)g/cm2 and(1.51±0.30)g/cm2 of the control group,with statistical significance(P<0.05).The first time of getting out of bed in the study group was(29.33±2.17)h,the postoperative bed time was(7.63±1.67)d,and the total hospitalization time was(12.31±1.49)d,which were shorter than(41.66±3.52)h,(14.35±2.58)d,and(17.68±2.18)d in the control group,the differences were statistically significant(P<0.05).At 7 days after operation,the Pain Visual Analogue score of the study group was(2.18±0.41)points,which was lower than(3.27±0.55)points of the control group,the difference was statistically significant(P<0.05).Two months after operation,the Ability Daily Living Scale score of the study group was(79.18±2.71)points,which was higher than(73.71±2.44)points of the control group,with statistical significance(P<0.05).The complication rate of fracture dislocation,wound infection and pulmonary infection in the study group was 0.00%,which was lower than 11.42%in the control group,with statistical significance(P<0.05).Conclusion:The effect of artificial hip replacement in elderly patients with intertrochanteric fractures is more ideal than that of proximal femoral intramedullary nail fixation,its safety ishigher,patientsrecover faster,and the applicationvalue is higher.