三种内固定方式治疗股骨粗隆间骨折的疗效比较  

An comparison of treatment effect of three internal fixation in intertrochanteric fractures

作　　者：张殿英[1] 姜保国[1] 傅中国[1] 

机构地区：[1]北京大学人民医院创伤骨科,100044

出　　处：《中华关节外科杂志（电子版）》2009年第3期23-26,共4页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：国家科技支撑计划资助项目(2007BAI04B06)

摘　　要：目的探讨动力髋螺钉(DHS)、股骨近端髓内钉(PFN)、股骨近端防旋髓内钉(PFN-A)在治疗股骨粗隆间骨折治疗中的疗效。方法对236例分别接受了DHS、PFN-A、PFN内固定手术的股骨粗隆间骨折患者进行回顾性研究,平均随访24个月,对住院时间,手术时间,术中出血量,术后引流量、患髋功能及并发症等作比较。结果PFN-A较PFN、DHS手术时间短,术中和术后出血量少,术后并发症少,术后愈合快。髋关节功能评分优良率:DHS组88.7%,PFN组90.2%,PFN-A组优良率91.6%。结论各种固定各有其自身特点,PFN-A是治疗各类型股骨粗隆间骨折较为理想的固定方式,尤其适用于骨质疏松的高龄粗隆间骨折、不稳定型骨折和合并症较多的患者。Objective To investigate treatment effect of dynamic hip screw （ DHS）, proximal femoral nail （PFN）, and proximal femoral nail anti-rotation （PFN-A）, three internal fixation in the femoral intertrochanteric fracture. Methods 236 cases of intertrochanteric fractures were retrospectively analyzed. Internal fixation was performed with the DHS, PFN, or PFN-A. Length of stay, operation duration t, blood loss during operation, drainage volume of blood, and function of effected hip were compared. Results With the average 24 months follow up after the operation, the result show that PFN-A is beter than PFN, DHS in operation duration, blood loss during operation, and complications. The fineness rate of DHS group was 88.7% , the fineness rate of PFN group was 90.2% , the fineness rate of PFN-A group was 91.6%. Conclusions Each group has its owe benefit. PFN-A is the ideal internal fixation for the treatment of all kind of femoral intertrochanteric fractures, especially for osteoprosis, unstable intertrachanteric fractures, and cases associated with much other diseases.

关 键 词：股骨粗隆间骨折 骨折固定术 内固定器 治疗结果 

分 类 号：R687.3[医药卫生—骨科学]