防旋自锁钢板与动力髋螺钉治疗骨质疏松股骨转子间骨折的临床研究  

Clinical study of dynamic hip screw and anti-rotatory self-locking plate in treatment of osteoporotic intertrochanteric fractures in elderlies

作　　者：赵玉[1] 吕浩然[1] 黄彦[1] 杨进顺[1] 

机构地区：[1]广州医科大学附属第二医院骨外科,510260

出　　处：《中华关节外科杂志（电子版）》2015年第3期6-9,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的比较采用防旋自锁钢板、动力髋螺钉(DHS)治疗骨质疏松患者股骨转子间骨折的术中情况、术后并发症及疗效。方法 2012年2月至2013年3月,分别采用防旋自锁钢板(22例)、DHS(36例)治疗,并随访老年股骨转子间骨折患者58例。比较两组患者手术情况、术后并发症及功能恢复情况。结果防旋自锁钢板组手术时间稍长,两治疗组手术时间比较无统计学差异(P>0.05);防旋自锁钢板组术中出血量略多于DHS组,两治疗组出血量比较无统计学差异(P>0.05);DHS组发生术后髋内翻、肢体短缩及并发症总数多于防旋自锁钢板(P<0.05)。DHS组、防旋自锁钢板组优良率分别为82.14%、95.00%,两组间疗效有统计学差异(P<0.05)。结论两种方法治疗老年骨质疏松患者股骨转子间骨折术中情况无差别;防旋自锁钢板术后并发症少、优良率高。Objective To compare the intra-operative blood loss and operation time,complications and therapeutic effects of dynamic hip screw（ DHS） and anti-rotatory self-locking plate in treating the osteoporotic intertrochanteric fractures. Methods From February,2012 to March,2013,58 elderly patients with intertrochanteric fractures were included in the study. Of all the patients,22 cases were treated by anti-rotatory self-locking plate,36 cases were treated by traditional DHS. All the cases were followed up. The intra-operative blood loss and operation time,complication incidences and postoperative hip function restoration of the two groups were compared. Results There was no significant difference in the mean operation time between the two groups（ P 〈0. 05）. The mean intraoperative blood loss in the antirotatory self-locking group was more than that in the DHS group（ P 0. 05）,yet the difference was not statistically significant. The complication incidence in the DHS group was significantly higher than the antirotatory self-locking group（ P〈 0. 05）. The rate of excellence and good results was 95% in the anti-rotatory self-locking group and 82. 14% in the DHS group with significant difference（ P〈 0. 05）. Conclusion There was no significant difference between the two operation methods as the operation effects were concerned. Anti-rotatory self-locking plate may reduce the complication incidence and increase the excellence rate.

关 键 词：骨质疏松 髋骨折 骨螺钉 骨板 

分 类 号：R687.3[医药卫生—骨科学]