人工双动股骨头置换术在偏瘫患者转子间骨折中的应用效果OA

Objective To investigate the therapeutic effect of bipolar hemiarthroplasty(BHA)for intertrochanteric fractures in patients with hemiplegia.Methods A total of 74 patients with hemiplegia due to intertrochanteric fractures who were admitted to Anyang People's Hospital from June 2020 to December 2023 were retrospectively selected.They were divided into the observation group(n=38)and the control group(n=36)based on different surgical methods.The observation group underwent BHA,while the control group received proximal femoral nail anti-rotation(PFNA)fixation.The perioperative indicators,fracture recovery-related indicators,hip joint function,balance ability,pain degree at different time points after surgery,and complication occurrence of the two groups of patients were observed.Results The intraoperative blood loss and total incision length in the observation group were greater or longer than those in the control group,and the postoperative ambulation time was shorter in the observation group than in the control group(P＜0.05).At one month after the operation,there was no significant difference in the excellent and good rate between the two groups(P＞0.05).The rank sum test showed that more patients in the observation group had hip joint function recovery to moderate than those in the control group(P＜0.05).At six months after the operation,the excellent and good rate of the hip joint function recovery in the observation group was higher than that in the control group,and the number of patients with hip joint function recovery to excellent in the observation group was also higher than that in the control group(P＜0.05).The Berg Balance Function Scale score of the observation group at 6 months after the operation was lower than that of the control group(P＜0.05).The visual analogue scale pain scores at 3 d and 7 d after the operation in the observation group were lower than those in the control group(P＜0.05).The total incidence of complications was[7.89％(3/38)]in the observation group,and[16.67％(6/36)]in the control group,showing no significant difference between the two groups(P＞0.05).Conclusion BHA for intertrochanteric fractures in patients with hemiplegia has more advantages in enabling early postoperative ambulation and the recovery of hip joint function.However,it is associated with poorer balance ability,a longer incision,and more intraoperative blood loss.In clinical practice,the surgical method can be selected based on the individual characteristics of the patients to achieve optimized therapeutic effects.