DHS与PFNA治疗股骨转子间骨折的疗效对比  

THE COMPARISON BETWEEN THE CURATIVE EFFECTS OF DHS AND PFNA ON FEMORAL FRACTURES BETWEEN ROTORS

作　　者：王相海[1] 王兴龙[1] WANG Xiang-hai WANG Xing-long(Linyi City Traditional Chinese Medicine Hospital, Linyi 276002, Chin)

机构地区：[1]临沂市中医医院骨二科,山东临沂276002

出　　处：《山东医学高等专科学校学报》2017年第4期287-290,共4页Journal of Shandong Medical College

摘　　要：目的比较动力髋螺钉(DHS)与股骨近端抗旋髓内钉(PFNA)在治疗股骨粗隆间骨折的临床疗效差异。方法收集临沂市中医院2009年1月~2016年11月期间,由于转子间骨折而采用DHS或PFNAN内固定手术者103例,其中DHS组46例,PFNA组57例。对比分析两组患者性别、年龄、手术时间、术中失血量、隐性失血量、围手术期出血量、卧床时间、住院时间、术后下地时间、骨折愈合时间、术后髋关节功能评分(Harris评分)、恢复伤前行走功能以及术后并发症情况等数据。结果两组患者在年龄、性别比较差异均无统计学意义(P>0.05)。术后随访11~15个月DHS组中有4例内固定失败或不愈合,PFNA组中有1例发生延迟愈合或不愈合。PFNA组较DHS组手术时间短、术中出血少、术后下地时间早、骨折愈合时间早、术后髋关节功能评分(Harris评分)高、恢复伤前行走功能早、术后并发症少(P<0.05)。结论 PFNA较DHS创伤小、术后并发症少、术后髋关节功能良好、恢复伤前行走功能早。Objective To compare the clinical curative effect of dynamic hip screw （DHS） and proximal femur anti-rotary intramedullary nails （PFNA） on femoral fractures between rotors. Methods 103 cases of femoral fractures between rotors were treated with internal fixation surgery by using DHS or PFNAN from January, 2009 to November 2016. DHS was used for 46 cases and PFNAN was used for 57 cases. The data on gender, age, operation time, intraoperative blood loss, hidden blood loss, perioperative blood loss, bed time, length of hospital stay, postoperative time of leaving bed, fracture healing time, postoperative hip joint function score （Harris score）,walking function before recovery and postoperative complications were compared between the two groups. Results No statistically significant difference was found in age and gender（ P 〉0.05）. The 11-15 month of follow-up surveys showed that DHS group had four cases of internal fixation failure or not healing. PFNA group showed shorter operation time, less intraoperative bleeding, earlier postoperative leaving bed, earlier fracture healing time, higher postoperative hip joint function score, earlier walking function recover and less postoperative complications（ P 〈0. 05）than the DHS group. Conclusion PFNA can be used to treat femoral fractures between rotors better than DHS.

关 键 词：股骨转子间骨折 动力髋螺钉 股骨近端抗旋髓内钉 疗效 

分 类 号：R683.42[医药卫生—骨科学]