老年股骨转子间骨折3种治疗方法临床疗效比较  

A Comparision of Three Surgeries in Treatment of Fermora Intertrochanteric in Elderly Patients

作　　者：王云琦[1] 祝静波[1] 姜少华[1] WANG Yun - qi ZHU Jing - bo JIANG Shao - ha(The second hospital of Shenyang medical university , Shenyang 110009)

机构地区：[1]沈阳医学院附属第二医院,辽宁沈阳110002

出　　处：《中国伤残医学》2017年第1期4-7,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：比较动力髋钢板，锁定加压接骨板，防旋股骨近端髓内钉治疗老年股骨转子间骨折的疗效。方法：回顾本院2010年9月一2014年9月间收治的96例老年股骨转子间骨折，其中DHS（动力髋钢板）组28例、LcP（锁定加压接骨板）组22例、PFNA（防旋股骨近端髓内钉）组46例的病例资料，比较手术切口长度、手术时间、术中出血量、术后引流量、住院天数、骨折愈合时间、术后并发症。结果：3组患者平均回访时间6～18个月，骨折全部愈合，平均愈合时间3～4个月，无切口感染及死亡病例。髋关节Harris评分，DHS组92．87％，LCP组90．90％，PFNA组93．47％。3组比较无差别（P〉0．05），手术切口长度、手术时间、术中出血量、术后引流量、住院天数、骨折愈合时间、术后并发症比较无差别（P〉0．05）。结论：3种方法均可有效治疗老年转手间骨折．临床疗效相仿．临床上需根据患者具体情况（年龄．体盾及骨折类型）．选撂合适的治疗方法．Objective： To investigate the efficacy of dynamic hip screw （DHS） ; locking compression plate （LCP） ; proximal femoral nail antirotation （PFNA）for the femoral intertrochanteric fracture in elderly patients. Methods： Retrospection was made on 96 patients in our department between September 2010 and September 2014, they were treated with dynamic hip screw（28 cases） ,locking compression plate （22 cases） , proximal femoral nail （46 cases）, Perioperative indices of patients were satistically analyzed, such as length of incision, oper- ation time, blood loss, drainage, time in hospital , time of fracture clinical healing and postoperative cmplication so on . Results：All the patients were followed up for 6 - 18 months, got bone union at average 3 -4 months, there are no death, no delayed healing. According to Harris criterion, the joint function score in DHS group were 92.87% on the average, LCP group were 90.90% on the average, PFNA group were 93.47% on the average, there were no significantly statistical differences in the joint ruction score and length of incision, oper- ation time, blood loss, drainage, time in hospital ,time of fracture clinical healing and postoperative complication （P 〉0. 05 ） . Conclu- sion ： Three kinds of treatment are effective for elderly patients＇the femoral intertrochanteric fracture, we should take the patients＇conditions （age, body constitution, fracture type） and choose a reasonable operation method.

关 键 词：股骨转子间骨折 动力髋钢板 锁定加压接骨板 防旋股骨近端髓内钉 

分 类 号：R681.6[医药卫生—骨科学]