动力髋螺钉与防旋型股骨近端髓内钉治疗高龄股骨粗隆间骨折早期疗效比较  

Early curative effects of dynamic hip screw or proximal femoral nail antirotation on femoral intertrochanteric fracture in elderly patients

作　　者：陈文学[1] 齐越峰[1] 郑移兵[1] 张雷[1] 

机构地区：[1]北京市丰盛中医骨伤专科医院骨2科,101400

出　　处：《中国医药》2014年第12期1787-1789,共3页China Medicine

摘　　要：目的 比较动力髋螺钉（DHS）和防旋股骨近端髓内钉（PFNA）治疗高龄股骨粗隆间骨折的早期疗效.方法 回顾性分析89例高龄股骨粗隆间骨折的患者,其中DHS治疗组43例,PFNA治疗组46例.评价2组的切口长度、术中出血量、手术时间、并发症和早期疗效等.结果 术后随访9 ～18个月,平均（11.6±2.2）个月.DHS组手术切口长度（9.8±1.3）cm,PFNA组手术切口长度（5.2±0.9）cm,2组比较差异有统计学意义（P＜0.05）;DHS组手术时间（85±16） min,PFNA组手术时间（46±11）min,DHS组术中出血量（150±30）ml,PFNA组术中出血量（50±11） ml,2组比较差异有统计学意义（P＜0.01）;并发症发生率：PFNA组为4.8％ （2/42）,DHS组为15.0％（6/40）,2组比较差异有统计学意义（P＜0.05）;Harris髋关节功能评分优良率：DHS组为75.0％（30/40）,PFNA组为90.5％（38/42）,2组比较差异有统计学意义（P＜0.05）.结论 PFNA治疗高龄股骨粗隆间骨折具有创伤小、并发症少、固定牢靠、抗旋转、抗切割等优点,但在适应证选择恰当的情况下,DHS及PFNA都是高龄股骨粗隆间骨折患者理想的内固定方式.Objective To compare the early efficiency of dynamic hip screw （DHS） and proximal femoral nail antirotation （PFNA） in treatment of elderly femoral intertrochanteric fracture patients.Methods Totally 89 cases of intertrochanteric fracture were retrospectively studied,including 43 patients in both DHS treatment group and DHS group,46 cases in the PFNA group.Incision length,operation time,postoperative complications and early efficacy were analyzed.All patients were followed up for 9 to 18 months with mean （11.6 ± 2.2） months.Results Incision length was （9.8 ± 1.3） cm in DHS group and （5.2 ± 0.9） cm in PFNA group; there was significant difference between two groups （P 〈 0.05）.Operation time was （85 ± 16） min in the DHS group and （46 ± 11） min in the PFNA group; average bleeding volume was （150 ±30） ml in the DHS group and （50 ± 11） ml in the PFNA group,there were significant differences between the two groups （P 〈 0.01 for both）.The overall complication rate was 4.8% （2/42）in the PFNA group,15.0% （6/40）in the DHS group; both groups had significant difference （P 〈 0.05）.The excellent and good rate of Harris hip score was 75.0% （30/40） in DHS group and 90.5 % （38/42） in the PFNA group ; both groups were statistically significant （P 〈 0.05）.Conclusions PF-NA treatment for elderly intertrochanteric fracture has advantages of few complications,stable fixation,anti-rotation and anti-cutting.When the indications are proper,DHS and PFNA are ideal fixations treating the elderly patients with the femoral intertrochanteric fractures.

关 键 词：股骨粗隆间骨折 动力髋螺钉 防旋型股骨近端髓内钉 早期疗效 

分 类 号：R619[医药卫生—外科学]