PFNA与DHS治疗股骨粗隆间骨折的疗效比较  

Comparison on the Curative Effect of the Treatment of Intertroc Anteric Fracture between the Proximal Femoral Nail Anti-rotation and the Dynamic Hip S crew

作　　者：康进军[1] 贺廷永[1] 邓杰[1] 丁龙镇[1] 

机构地区：[1]山西大同同煤集团总医院骨科,山西大同037003

出　　处：《实用骨科杂志》2013年第6期497-500,共4页Journal of Practical Orthopaedics

摘　　要：目的通过设立临床随机对照试验,就防旋型股骨近端髓内钉(proximal femoral nail antirotation,PFNA)与动力髋螺钉(dynamic hip screw,DHS)治疗股骨粗隆间骨折的疗效进行比较,为股骨粗隆间骨折手术方案中内植物的选择提供临床依据。方法 2010年1月至2011年12月收治的78例股骨粗隆间骨折患者,男30例,女48例;年龄57～76岁,平均年龄66岁。其中41例采用PFNA手术治疗(试验组);37例采用DHS手术治疗(对照组),进行切开复位内固定术,观察比较两组各项指标、术后恢复情况。结果经统计学分析,试验组切口长度短于对照组(t=12.469,P<0.001),试验组术中出血量少于对照组(t=130.22,P<0.001),试验组手术时间短于对照组(t=52.116,P<0.001),试验组骨折愈合时间短于对照组(t=23.034,P<0.001)。功能预后按Harris评定标准进行疗效评价,经统计学分析,试验组优良率高于对照组(χ2=4.321,P=0.038)。结论两组在治疗期间各项指标、术后功能评定方面比较,有显著性差异,试验组优于对照组。说明防旋型股骨近端髓内钉治疗股骨粗隆间骨折临床效果满意,值得推广。Objective To provide clinical evidences for the selection of the implant in the treatment of in- tertrochanteric fracture by means of clinical randomized trials and the comparison on the curative effectiveness of the treatment of intertrochanteric fracture between the Proximal femoral nail anti-rotation and the Dynamic hip screw. Methods From January 2010 to December 2011,78 patients with Intertrochanteric fracture were treated,including 30 men, 48 women ,aged from 57 to 76 years ,with an average age of 66 years. Among them, 41 patients were treated with the Proximal femoral nail anti rotation（experimental group）;37 cases with the Dynamic hip screw （control group）. Results After statistics analysis,compared to the control group,experimental group incision length was shorter （t= 12. 469,P^0. 001）~blood loss was less （t=130.22,P^0. 001）;operation time was shorter 0--52. 116,P^0. 001）, fracture healing time was shorter （t= 23. 034,P%0. 001）. Functional outcome was evaluated according to the stan- dard of Harris and the excellent and good rate of the test group was higher than that of the control group （~2=4. 321, P = 0. 038）. Conclusion The treatment of Intertrochanteric fracture using the proximal femoral nail anti-rotation is satisfying ,and is worthy of clinical popularization.

关 键 词：防旋型股骨近端髓内钉 动力髋螺钉 股骨粗隆间骨折 疗效 

分 类 号：R683.42[医药卫生—骨科学]