DHS和PFNA对高龄股骨粗隆间不稳定型骨折的疗效及安全性分析  

Analysis on the clinical safety and efficacy of DHS and PFNA for unstable intertrochanteric fractures in elderly patients

作　　者：阮传江[1] RUAN Chuanjiang(Department of Orthopaedics,People＇s Hospital of Taihe County,Taihe 236600,Chin)

机构地区：[1]太和县人民医院骨三科,安徽太和236600

出　　处：《皖南医学院学报》2018年第4期353-355,359,共4页Journal of Wannan Medical College

摘　　要：目的:观察动力髋螺钉(DHS)与股骨近端抗旋髓内钉(PFNA)对高龄股骨粗隆间不稳定型骨折的临床疗效。方法:选取我院2011年1月~2016年1月收治的股骨粗隆间不稳定型骨折患者40例,分为研究组和对照组,研究组采用PFNA进行治疗,对照组采用DHS进行治疗。结果:研究组优良率为85.0%,对照组优良率为45.0%,研究组优良率升高且差异有统计学意义(P<0.05)。与对照组相比,研究组的术中出血量增多、下地活动时间减少,差异有统计学意义(P<0.01);研究组的手术时间长于对照组,但差异无统计学意义(P>0.05)。与对照组相比,研究组术后3、6个月Harris骸关节评分下降(P<0.05);术后12个月评分上升,差异有统计学意义(P<0.05)。研究组出现1例假体周骨折(5.0%),对照组出现6例(30.0%),研究组并发症发生率较低(χ2=4.331,P<0.05)。结论:PFNA较DHS在治疗高龄股骨转子间骨折患者时具有创伤小、下地活动时间短、Harris髋关节功能评分较高、并发症少等优点,具有临床应用推广价值。Objective： To assess the clinical safety and efficacies of dynamic hip screw（ DHS） and proximal femoral nail antirotation（ PFNA） in the treatment of unstable intertrochanteric fractures in elderly patients. Methods： Forty patients with unstable intertrochanteric fractures admitted to and treated in our hospital were included from January of 2011 to 2016,and randomly allocated to study group and control group. Patients in the study group received PFNA,and those in the control group were treated with DHS. Results： The excellent rate was 85% in the study group and 55% in the control group. The difference was significantly（ P〈 0. 05）. Patient in the study group had higher intraoperative blood loss and fewer off-bed activities than those in the control group（ P〈 0. 01）. Although the study group had longer operative time,yet the difference was insignificant between group（ P〉 0. 05）. Patients in the study group had significantly lower Harris hip scoring at 3 and 6 months,yet increased scoring at 12 months after operation（ P〈 0. 05）. Fracture of the prosthesis occurred in one case in the study group（ 5%）,and in 6（ 30%） in the control group. The study group had significantly lower complications（ χ2= 4. 331,P〈 0. 05）. Conclusion： PFNA can lead to minimal trauma,early off-bed activity,higher Harris hip scoring and reduced postoperative complications than DHS in the treatment of elderly patients with unstable intertrochanteric fractures,and is worthy of wider clinical recommendation.

关 键 词：动力髋螺钉 股骨近端抗旋髓内钉 股骨粗隆间不稳定型骨折 

分 类 号：R687.3[医药卫生—骨科学]