动力髋螺钉和防旋股骨近端髓内钉治疗老年骨质疏松性股骨转子间骨折的早期疗效评价  

DHS and PFNA treatment in old patient osteoporotic femoral intertrochanteric fracture:early curative effect

作　　者：陈柯[1] 刘立云[2] 

机构地区：[1]河南洛阳正骨医院,洛阳471000 [2]湖南中医药大学

出　　处：《中国矫形外科杂志》2011年第10期801-803,共3页Orthopedic Journal of China

摘　　要：[目的]比较采用动力髋螺钉（dynamic hip screw,DHS）和防旋股骨近端髓内钉（proximal femoral nail antirotation,PFNA）治疗老年骨质疏松性股骨转子间骨折的早期疗效。[方法]对112例老年骨质疏松性股骨转子间骨折的患者进行治疗并随访。DHS治疗组58例,PFNA治疗组54例。从术中情况、术后并发症及疗效方面对两种治疗方法的临床早期疗效进行比较分析。[结果]术后经9~18个月随访,平均12.9个月。两组间切口长度、负重时间比较有统计学意义（P〈0.05）;手术时间、术中平均出血量比较有显著性统计学意义（P〈0.01）;两组并发症发生率有统计学差异,PFNA组并发症总发生率低于DHS组;两组治疗优良率比较具有统计学意义（P〈0.05）,PFNA组治疗效果明显优于DHS组。[结论]PFNA治疗老年骨质疏松性股骨转子间骨折具有创伤小、并发症少、固定牢靠、抗旋转、抗切割等优点,是临床上治疗老年骨质疏松性股骨转子间骨折理想的内固定物。[Objective]To compare the early results of using dynamic hip screw（DHS） and proximal femoral nail antirotation（PFNA） in treatment of osteoporotic femoral intertrochanteric fracture.[Method]A total of 112 elderly patients with osteoporosis and femoral intertrochanteric fracture were treated,58 cases with DHS treatment,and 54 cases with PFNA treatment.Peri-and postoperative complication and efficacy of 2 methods were compared and the early clinical result was analyzed.[Result]All patients were followed up for an average of 12.9 months（ranged,9-18 months）.The length of incision and the weight bearing time showed statistical difference（P0.05）.The operation time,intraoperative blood loss showed statistically significant difference（P0.01）.Complication rate in PFNA group was lower than that in DHS group.The good to excellent rate in PFNA group was higher that that in DHS group,with statistically significant difference（P0.05）.[Conclusion]PFNA treatment for osteoporotic intertrochanteric fracture has advantages of less complication,stable fixation,anti-rotation,anti-cutting,et al.It is an ideal clinical treatment.

关 键 词：骨质疏松 股骨转子间骨折 动力髋螺钉 防旋型股骨近端髓内钉 早期疗效 

分 类 号：R687.3[医药卫生—骨科学]