股骨近端解剖锁定板与动力髋螺钉治疗股骨粗隆间骨折的疗效对比分析  

Efficacy comparison of dissection locking proximal femoral bone plate and dynamic hip screws in the treatment of femoral intertrochanteric fracture

作　　者：李秋举[1] 林国兵[1] 陈雄[1] 郭文荣[1] 洪志群[1] 王怀云[1] 陈祥[1] 李远东[1] 

机构地区：[1]南京军区福州总医院第一附属医院,福建莆田351100

出　　处：《生物骨科材料与临床研究》2011年第3期19-22,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的评价股骨近端解剖锁定板与动力髋螺钉治疗股骨粗隆间骨折的疗效。方法回顾分析2007年7月~2009年1月收治并随访的58例股骨粗隆间骨折患者,分别采用股骨近端解剖锁定板（LPFP）和动力髋螺钉（DHS）进行治疗,根据Evans分型,其中EvansⅠ、Ⅱ型23例,采用LPFP固定8例,采用DHS固定15例;EvansⅢ、Ⅳ、Ⅴ型35例,采用LPFP固定22例,采用DHS固定13例,分别从术中情况、术后恢复及术后患髋功能进行分析比较。结果手术时间、术中及术后出血量、术后患髋关节功能LPFP组与DHS组有明显差异（〈0.05）,即两组相比LPFP组手术时间短,术中出血量少及术后引流量少,术后髋关节功能恢复好,但住院费用费用高;两组的切口长度、术中透视次数和骨折愈合时间相当（〉0.05）。结论对于EvansⅠ、Ⅱ型两种固定方法均可,但对于EvansⅢ、Ⅳ、Ⅴ型股骨近端解剖锁定板明显优于动力髋螺钉。Objective To evaluate the effect of dissection locking proximal femoral bone plate and dynamic hip screws in the treatment of femoral intertrochanteric fracture.Methods There were 58 cases with intertrochanteric hip fracture from July 2007 to January 2009 were followed up.They were treated with the 2 kinds of operations respectively： Locking proximal femurs plate,Dynamic hip screw.According to Evans classification of intertrochanteric fracture,23 cases were type Ⅰ、Ⅱof which 8 cases were treated with LPFP,15 cases treated with DHS;35 cases were type Ⅲ、Ⅳ、Ⅴof which 22 cases were treated with LPFP,13 cases treated with DHS.The date of each group were collected for statistical analysis on the following aspects ： circumstance of operation,resumes after operation functional outcome.Result The differences of the operative time,blood loss and drainage,functional outcome after operation between dissection locking proximal femoral bone plate and dynamic hip screws.Compared with dynamic hip screws,dissection locking proximal femoral bone plate had shorter operative time,fewer bloods loss and drainage,functional outcome better,but more hospitalized expenses.No differences of fluoroscopy exposures,bone fracture heals time,length of operation slices between two groups.Conclusion For Evans Ⅰ、Ⅱfracture,two groups are all applicable.For Evans Ⅲ、Ⅳ、Ⅴ fracture,dissection locking proximal femoral bone plate better than dynamic hip screws.

关 键 词：股骨粗隆间骨折 DHS 锁定板 疗效 

分 类 号：R687.3[医药卫生—骨科学]