DHSA与DHS治疗老年股骨粗隆间骨折的疗效比较  

Difference between DHSA and DHS for treatment of femoral intertrochanteric fracture in elderly patients

作　　者：岳勇[1] 赵东风[1] 刘欣伟[1] 王瑀[1] 孙皓[1] 江洪洋[1] 

机构地区：[1]解放军第210医院骨科,辽宁大连116021

出　　处：《临床军医杂志》2015年第3期251-253,273,共4页Clinical Journal of Medical Officers

摘　　要：目的比较动力髋螺旋导片系统（DHSA）与动力髋螺钉（DHS）在治疗老年股骨粗隆间骨折中的近期疗效。方法对2011年1月—2013年1月间在我科治疗的68例65岁以上股骨粗隆间骨折患者,随访12-35（23.5±2.3）个月。68例中DHS组37例,DHSA组31例。比较两组患者术前基本情况及术中平均手术时间、平均出血量、术后内固定有否切出股骨头、术后骨折平均愈合时间、术后12个月时髋关节Harris评分。结果两组患者的术前一般资料比较差异无统计学意义（P〉0.05）;所有病例在随访时间内未发现感染。DHSA组无骨折不愈合、无刀片切出股骨头,DHSA组术中出血量少、手术时间短,骨折愈合快,术后12个月Harris评分明显高于DHS组（P〈0.05）。结论 DHSA与DHS均可实现老年股骨粗隆间骨折的良好固定,而DHSA固定技术具有手术创伤小,内固定物可填压松质骨,切出率低,抗旋转,固定可靠,对于骨质疏松性股骨粗隆间骨折患者更加合理、有效。Objective To explore the recent curative effects of dynamic hip screw guide system and dynamic hip screw（ DHS） in the treatment of elder femoral intertrochanteric fracture. Methods We retrospectively studied 68 patients over the age of 65 who suffered from femoral intertrochanteric fractures and treated with DHS（ n = 37） or DHSA（ n = 31） from Jan 2011 to Jan 2013. The period of follow-up was 12 to 35（ 23. 5 ± 2. 3） months. We compared preoperative basic information,average operation time,intraoperative blood loss and so on. Results Preoperative basic information of the two groups had no statistically significant difference（ P〉0. 05）. No infection and cut-out of femoral head occurred in DHSA group,in which shorter operation time,less intraoperative bleeding and faster healing were found. Postoperative Harris score（ 12 months） was significantly higher in the DHSA group than in the DHS group（ P〈0. 05）. Conclusion Both the DHSA and DHS can achieve good fixation for elderly femoral intertrochanteric fractures. DHSA technology has advantage over DHS such as reliable fixation,anti-rotation and less surgical trauma.

关 键 词：动力髋螺旋导片 动力髋螺钉 粗隆间骨折 老年人 

分 类 号：R683.42[医药卫生—骨科学]