股骨近端防旋髓内钉与动力髋螺钉治疗老年人股骨粗隆间骨折的疗效比较  

Comparison of the effect between PFNA with DHS in the treatment of intertrochanteric fracture in elderly case

作　　者：毛琦[1] 龚志锋[1] 蓝子江 吴元元[1] 胡钊[1] 

机构地区：[1]浙江省泰顺县人民医院骨科,325500

出　　处：《中国基层医药》2013年第1期44-46,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 比较股骨近端防旋髓内钉（PFNA）与动力髋螺钉（DHS）治疗老年人股骨粗隆间骨折的临床疗效。方法 分析58例股骨粗隆间骨折患者临床资料,其中30例行DHS固定,28例行PFNA固定,比较两组手术时间、手术出血量、并发症发生率和Harris评分等,评价两者的临床疗效。结果 PFNA组手术时间［（59.61±8.27）min］、手术出血量［（234.51±38.80）ml］等方面均优于DHS组［（83.54±11.12）min、（446.57±54.01）ml］（t=9.80、18.10,P〈0.05）;PFNA组髋关节功能恢复总优良率为92.8%,DHS组为83.3%,差异有统计学意义（χ2=6.18,P〈0.05）,PFNA组内固定失效、股骨头切割、髋内翻等术后并发症发生率低于DHS组。结论 PFNA内固定治疗老年人粗隆间骨折具有创伤小、固定稳、恢复快等优点,是治疗老年人股骨粗隆间骨折较理想的方法。Objective To compare the clinical effects of proximal femoral nail antirotation （PFNA） and dynamic hip screw （DHS） in the treatment of intertrochanteric fractures in elderly patients.And provide a reasonable basis for clinical treatment of elderly patients with intertrochanteric fractures.Methods The clinical and follow-up records of 58 elderly patients with intertrochanteric fractures treated by PFNA and DHS were retrospectively reviewed.For times of operation,blood loss in operation,length of incision,incidents of complication and Harris′s hip functional standard score were compared and analyzed.Results PFNA group operation time[（59.61±8.27）min],amount of bleeding[（234.51±38.80）ml] were both better than the DHS group of[（83.54±11.12）min and （446.57±54.01）ml]respectively.There were significant differences（t=9.80,18.10,all P〈0.05）.The satisfactory rate was 92.8% in PFNA group,higher than the DHS group′s 83.3%（χ2=6.18,P〈0.05）.There was significant difference between two groups in the incident of complication,DHS group was higher. Conclusion PFNA internal fixation with a minimally invasive,fixed solid and recovery fast,is the better internal fixation in the treatment of elderly intertrochanteric fracture patients.

关 键 词：骨钉 骨折固定术 髓内 股骨骨折 

分 类 号：R687.3[医药卫生—骨科学]