股骨偏心距改变对老年股骨转子间骨折术后功能影响

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Abstract Objective To investigate the effects of altering the femoral offset on the postoperative function of femoral trochanteric fracture in elderly people.Methods A total of 96 patients undergoing single femoral trochanteric fracture closed and internal fixation between September 2017 and June 2019 met the inclusion criteria.According to difference of femoral offset between operative side and contralateral side，the patients were divided into 3 groups：decreased offset group (<－5 mm，34 cases)，normal offset group(－5~5 mm，32 cases)，and increased offset group (>5 mm，30 cases).The reduction group had 34 patients inincluding 14 males and 20 females.The average age was (77.47±8.12)years old.There were 19 stable fractures and 15 unstable fractures.Among them，there were 9 ASA Ⅱ level and 25 ASA Ⅲ level.T the normal group had 32 patients，including 13 males and 19 females.The average age was (80.09±7.17)years old.There were 20 stable fractures and 12 unstable fractures.Among them，there were 8 ASA level Ⅱ，24 ASA level Ⅲ.The enlarged group had 30 patients，including 9 males and 21 females.The average age was (81.00±7.63)years old.There were 20 stable fractures and 10 unstable fractures.Among them，there were 6 ASA level Ⅱ，24 ASA level Ⅲ.Clinical efficacy was evaluated by Harris score 3 months，6 months and 1 year after surgery.Results There were no statistically significant differences in age，gender，fracture type，ASA grading and postoperative hemoglobin among the three groups (P＞0.05).3 months and 6 months after surgery Harris score in the decrease group was higher than that in the normal group and the increase group，and the difference was statistically significant (P＜0.05).Harris score 1 year after surgery showed no statistically significant difference between the normal group and the decrease group (P＞0.05)，The scores of the increased group at 3 months，6 months and 1 year after surgery were lower than those of the normal group and the decreased group，with statistically significant differences (P＜0.05).Conclusion Femoral offset affects postoperative function of patients with intertrochanteric fracture.Postoperative offset decrease can promote early recovery of femoral trochanteric fracture，reduce pain，and improve the quality of life.Postoperative offset increase will delay the recovery of patients，postoperative joint function score is lower.

Key words： intertrochanteric fracture femoral offset joint function joint pain

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