老年股骨粗隆间骨折三种内固定方式治疗的疗效比较  

Effect comparion of three kinds of internal fixation treatment in elderly patients with femoral intertrochanteric fracture

作　　者：雷军 王军伟 

机构地区：[1]西安市高陵区医院骨科,陕西西安710200 [2]西安市红会医院关节外科,陕西西安710000

出　　处：《临床医学研究与实践》2017年第32期76-78,共3页Clinical Research and Practice

摘　　要：目的比较动力髋螺钉(DHS)、股骨近端解剖型锁定钛板(ALP)与股骨近端抗旋髓内钉(PFNA)治疗老年股骨粗隆间骨折的疗效。方法回顾性分析2009年1月至2015年9月收治的106例老年股骨粗隆间骨折患者的临床资料,35例患者采用DHS内固定(DHS组);34例患者采用锁定板(ALP组);37例患者采用PFNA内固定(PFNA组)。比较三组患者的手术时间、术中出血量、术后引流量、骨折愈合时间。髋关节Harris评分及并发症的发生率等。结果 PFNA组患者手术时间、术中出血量、术后引流量、骨折愈合时间优于DHS组和ALP组;患者髋关节Harris评分显著高于DHS组和ALP组;PFNA组并发症总发生率低于DHS组和ALP组,差异均有统计学意义(P<0.05)。结论 DHS、ALP及PFNA均可用于治疗老年股骨粗隆间骨折,但对于老年的股骨粗隆间骨折PFNA固定更适宜。PFNA内固定治疗老年股骨粗隆间骨折效果更理想。Objective To compare lhe curalive effecl of lhe dynamic hip screw （ DHS）, proximal femur analomic locking lilanium plale （ ALP） and proximal femur anli rolary inlramedullary nailing （ PFNA） in lhe lrealmenl of femoral inlerlrochanleric fraclure. Methods A relrospeclive analysis of 106 cases of elderly palienls wilh femoral inlerlrochanleric fraclure from January 2009 lo Seplember 2015 was performed. Thirly-five palienls receiving DHS inlernal fixalion were selecled as lhe DHS group, 34 cases lrealed by locking plale were selecled as lhe ALP group, 37 cases receiving inlernal fixalion wilh PFNA were selecled as lhe PFNA group. The operalion lime, inlraoperalive blood loss, posloperalive flow, fraclure healing lime, lhe Harris hip scores and lhe incidence of complicalions of lhe lhree groups were compared. Results The operaling lime, inlraoperalive blood loss, lhe flow rale and fraclure healing lime of lhe PFNA group were beller lhan lhose of lhe DHS group and ALP group; lhe Harris hip scores of PFNA group was higher lhan lhal of lhe DHS group and ALP group; lhe incidence of complicalions of lhe PFNA group was lower lhan lhal of lhe DHS group and ALP group, all lhe above differences were slalislically significonl （ P〈0.05）. Conclusion DHS, ALP and PFNA can be used in lhe lrealmenl of senile femoral inlerlrochanleric fraclure, bul PFNA inlerlrochanleric fraclures fixlion was more appropriale for lhe elderly. The effect of PFNA in elderly palienls wilh femoral inlerlrochanleric fraclures is more ideal.

关 键 词：股骨骨折 DHS钢板 ALP钛板 PFNA髓内钉 

分 类 号：R687.3[医药卫生—骨科学]