DHS与PFNA治疗老年股骨转子间骨折疗效比较  

Curative effects of using DHS and PFNA for intertrochanteric fracture in the elderly

作　　者：朱定川[1] 刘雷[2] 高峰[1] 

机构地区：[1]四川大学华西医院西藏成办分院骨科,四川成都610041 [2]四川大学华西医院骨科,四川成都610041

出　　处：《局解手术学杂志》2013年第1期18-20,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨对比老年患者股骨转子间骨折使用动力髋螺钉(DHS)与股骨近端螺旋刀片抗旋髓内钉(PFNA)治疗的相关疗效。方法 2006年至20012年在我科收治的59例老年股骨转子间骨折患者中,对28例老年股骨转子间骨折患者应用DHS内固定,31例老年股骨转子间骨折患者应用PFNA内固定,评价治疗效果。结果 59例患者,随访到56例,随访时间12～18个月,平均16.7个月,无内固定松动、断裂、外露及脱落情况。DHS组手术时间为107～153 min,术中出血量为200～300 mL,下地行走时间为6～8周,骨折愈合时间为12～20周;PFNA组手术时间为45～115 min,术中出血量为120～230 mL,下地行走时间为5～7 d,骨折愈合时间为6～8周。在手术时间及术中出血量及下地功能锻炼时间方面,2组差异有显著性意义。结论 DHS及PF-NA均是治疗老年股骨转子间骨折的有效方法,应用PFNA的病例,手术时间短,术中出血量更少,创伤小,下地功能锻炼时间早,骨折愈合快,有效地避免长期卧床的并发症。Objective To discuss and compare the curative effects of using dynamic hip screw（DHS） and proximal femoral nail anti-rotation blade（PFNA） for intertrochanteric fracture in the elderly.Methods Among 59 elderly persons with intertrochanteric fracture,who were treated in our department from 2006 to 2012,DHS internal fixation was adopted for 28 persons and PFNA internal fixation for the rest 31 persons.A comparison was made to evaluate curative effect of them.Results A follow-up survey was conducted among 56 of them for 12 to 18 months（averagely 16.7 months）.There was no loosing,breaking,exposure nor falling off in terms of the status of internal fixation.For DHS treatment group,the surgery lasted for 107 to 153 minutes,during which the amount of bleeding was 200-300 mL.It took 6 to 8 weeks for them restore to the extent that they were capable of walking,and it took 12 to 20 weeks to cure the fracture.For PFNA group,the surgery lasted for 45 to 115 minutes,during which the amount of bleeding was 120 to 230 mL.It took 5 to 7 days for them restore to the extent that they were capable of walking,and it took 6 to 8 weeks to cure the fracture.The difference of two groups in duration of surgery,amount of bleeding and the time of walking exercises were of a significant meaning.Conclusion The conclusion is that both DHS and PFNA are effective methods to treat intertrochanteric fracture in the elderly.For those with PFNA therapy,the surgery could be finished in a shorter time with less amount of bleeding and smaller trauma;and it was possible for them to walk and heal over earlier.It could effectively avoid complication arising from long-term bed.

关 键 词：股骨转子间骨折 老年 骨折内固定术 

分 类 号：R683.42[医药卫生—骨科学]