3种内固定方法治疗老年骨质疏松性股骨粗隆间骨折的疗效对比  

Comparative Study on the Curative Effect of Three Internal Fixation Methods in the Treatment of Femoral Intertrochanteric Fracture of Elderly Patients

作　　者：汪军[1] 

机构地区：[1]阆中市人民医院骨科,阆中637400

出　　处：《成都医学院学报》2015年第3期354-356,359,共4页Journal of Chengdu Medical College

摘　　要：目的比较防旋型股骨近端髓内钉（PFNA）、Gamma钉以及动力髋螺钉（DHS）3种内固定方法治疗老年骨质疏松性股骨粗隆间骨折的临床效果。方法选取2012年1月至2014年3月阆中市人民医院骨科收治的老年骨质疏松性股骨粗隆间骨折患者90例,PFNA固定患者32例（A组）,Gamma钉固定患者23例（B组）,DHS固定患者35例（C组）。观察3组患者手术情况、治疗效果、手术前后关节功能变化及并发症发生情况。结果 3组手术时间及术中出血量比较,差异有统计学意义（P〈0.01）;C组治疗优良率明显低于A、B组,差异有统计学意义（P〈0.01）;3组术前Harris评分比较,差异无统计学意义（P〉0.05）,术后3个月,C组Harris评分明显低于A、B组（P〈0.01）;随访6-12个月,3组并发症发生率比较,差异有统计学意义（P〈0.01）,其中A组最低,C组最高。结论在老年骨质疏松性股骨粗隆间骨折治疗中,PENA疗效优于DHS,与Gamma钉相当,但其安全性更高、预后较好。Objective To investigate clinical effect by using three internal fixation methods including proximal femoral nail（PFNA）,Gamma nail and dynamic hip screw（DHS）in elderly osteoporotic intertrochanteric fracture.Methods 90 cases of elderly osteoporotic intertrochanteric fracture patients came from our hospital from January2012 to March 2014,with 32 patients used fixed PFNA（group A）,23 patients used Gamma nail（group B）and35patients used DHS（group C）.Operative situation,therapeutic efficacy,changes of joint function before and after surgery and occurrence of complications were observed in three groups.Results Operation time and blood loss were significantly different among the three groups（P〈0.01）.Excellent and good rates of group A and B were 87.50%and 86.96%,respectively,which were not significantly different between the two groups（P〉0.05）;excellent and good rate of group C was 68.57%,which was significantly lower than the other two groups（P〈0.01）.Harris scores of three groups were not significantly different before surgery（P〉0.05）;postoperative three months,Harris score of group C was significantly lower than groups A and B（P〈0.01）.After 6to 12 month follow-up,complication rates of the three groups were significantly different,with the lowest in group A and the highest in group C（P〈0.01）.Conclusion PENA,which is not significantly different compared with Gamma,is better than DHS.Furthermore,PFNA is more secure and the prognosis is better.

关 键 词：股骨粗隆间骨折 骨折疏松 内固定 临床效果 

分 类 号：R687.3[医药卫生—骨科学]