防旋股骨近端髓内钉和动力髋部螺钉治疗股骨转子间骨折临床疗效的比较  

Comparison of therapeutic effect of PFNA with DHS in intertrochanteric fractures

作　　者：左文山[1] 戴志堂[1] 田纪伟 

机构地区：[1]南京医科大学附属淮安第一医院骨二科,江苏淮安223300 [2]上海市长征医院骨科,上海200433

出　　处：《中国现代医学杂志》2011年第4期475-478,共4页China Journal of Modern Medicine

摘　　要：目的观察老年患者转子间骨折的防旋股骨近端髓内钉(PFNA)的治疗效果,并与传统的动力髋部螺钉(DHS)比较疗效。方法收集该科60岁以上老年的股骨转子间骨折、经住院手术及随访12个月以上(平均18个月)的54例患者的资料,其中PFNA治疗26例,DHS治疗28例,对切口长度、手术操作时间、术中失血量、累积透视时间、住院时间、术后疗效及并发症等进行逐项总结和比较。结果两组的平均切口长度、手术时间、术中失血量、累计透视时间、住院时间、髋内翻和CUT-OUT发生率的差异有显著性(P<0.05)。采用PFNA内固定和DHS内固定手术的术后1年疗效评价,优良率分别为84.6%和78.6%,两者结果的差异无显著性(P>0.05),但是PFNA组发生髋内翻畸形和CUT-OUT总共只有1例(占3.8%),DHS组有6例(占21.4%),两组之间差异有显著性(P<0.05)。结论 PFNA治疗老年股骨转子间骨折具有方法简单、伤口暴露小、手术时间短、手术出血量少、创伤小及住院时间短等优点,PFNA适合治疗老年人股骨转子间骨折。【Objective】 To observe the therapeutic effect of PFNA in intertrochanteric fractures,and compare it with traditional DHS.【Methods】 Fifty-four intertrochanteric fracture patients all over 60 years were assigned two groups,and all followed up over 12 months.Twenty-six patients were treated with PFNA,twenty-eight patients were treated with DHS.Wound length,operation time,blood loss,total X-ray exposure time,inpatient time,therapeutic effect and complications were recorded and compared in two groups.【Results】 There was significant difference in the average wound length,operation time,blood loss,total X-ray exposure time,inpatient time（P 0.05）.There were no significant difference in the excellent and good rate in the PFNA（84.6%）and DHS（78.6%）（P 0.05）.There were significant difference in the rate of postoperative complications of Coxa Vara and CUT-OUT in PFNA（3.85%） and DHS（21.4%） and the joint function recovery of three groups.【Conclusion】 PFNA has advantages with less operating time,less exposure,less blood loss,less trauma,and shorter hospitalization.PFNA is a better way in the elder patients of intertrochanteric fractures treatment.

关 键 词：股骨转子间骨折 防旋股骨近端髓内钉(PFNA) 动力髋部螺钉(DHS) 

分 类 号：R681.42[医药卫生—骨科学]