改良动力髋螺钉与股骨近端髄内钉治疗老年股骨粗隆间骨折的比较  

Improved dynamic hip screw and proximal femur marrow nail in treatment of senile intertrochanteric fracture

作　　者：范立洪 沈光银 

机构地区：[1]扬州市中医院骨科,江苏扬州225000 [2]扬州东方医院骨科

出　　处：《中国伤残医学》2013年第12期3-5,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:比较改良动力髋螺钉与股骨近端髄内钉(PFN)治疗老龄股骨粗隆间骨折的方法及疗效。方法:对60例老龄股骨粗隆间骨折的患者,随机运用改良DHS与PFN治疗,比较2组术后并发症及关节功能。结果:2组比较:DHS组在切口长度、手术时间及术中出血量均大于PFN组,差异具有统计学意义(P<0.05)。术后1年:DHS组出现滑动髁螺钉退出3例,切割股骨头穿出1例,均发生于Ⅳ型骨折。其中出现髋内翻2例,发生于内侧结构不稳病例。PFN组无内固定断裂及髋内翻等并发症发生,出现2例螺钉退出,2组并发症比较(p<0.05)差异有统计学意义。Harris髋关节评分PFN优于DHS组,但2组比较(p>0.05)差异无统计学意义。结论:2种手术治方法均有各自优势,对于粉碎性或骨质疏松性股骨粗隆间骨折,宜选用PFN治疗。objective：To compare the improved dynamic hip screw and the proximal femoral marrow inner nail （PFN） aging treatment of intertrochanteric fractures of the method and curative effect. Methods ：60 cases of elderly patients with intertrochanteric fracture, a ran- dom using modified PFN and DHS treatment, compared two groups of postoperative complications and joint function. Results：Two groups of comparisons： DHS group in incision length, operative time and intraoperative blood loss were greater than PFN group, difference has statistical significance （ P 〈 0.05 ）. One year after surgery ： DHS group appear sliding condyle screw exit 3 cases, cutting wear out in 1 case, femoral head occurred in IV type fractures. Including a hip varus in 2 cases, unstable cases happens on the inside of the structure. PFN group internal fixation of fracture and complications, such as hip varns in 2 cases of screw exit, compare of complications in two groups （ p 〈 0.05 ） difference was statistically significant. Harris hip score PFN is better than DHS group, but compared two groups there was no statistically significant difference （ p 〉 0.05 ）. Conclusion： Two kinds of surgical methods may have their respective advantages, for eomminuted or osteoporotic intertrochanteric fractures, appropriate chooses PFN treatment.

关 键 词：股骨粗隆间骨折 DHS PFN 

分 类 号：R683.4[医药卫生—骨科学]