不同内固定方法治疗老年股骨粗隆间骨折的疗效比较  

Comparative analysis of different internal fixation methods for intertrochanteric femoral fractures in the elderly

作　　者：冯康[1] 田园 FENG Kang;TIAN Yuan(Department of Orthopaedics,the Second People’s Hospital of Lianyungang,Lianyungang 222023,China)

机构地区：[1]连云港市第二人民医院骨科

出　　处：《实用老年医学》2019年第12期1229-1232,共4页Practical Geriatrics

摘　　要：目的分析并比较老年股骨粗隆间骨折采用闭合复位股骨近端螺旋刀片抗旋髓内钉(PFNA)内固定和切开复位动力髋部螺钉(DHS)内固定的疗效。方法选取2015年1月至2017年12月我院收治的100例老年股骨粗隆间骨折病人,根据治疗方法将其分为观察组53例和对照组47例。观察组采用闭合复位PFNA内固定治疗,对照组采用切开复位DHS内固定治疗,评估并比较2组的各项治疗指标、治疗优良率以及并发症发生率。结果 2组手术时间、术中出血量、住院时间差异均无统计学意义(P>0.05),观察组手术费用明显高于对照组(P<0.05)。观察组治疗优良率高于对照组,但差异无统计学意义(P>0.05)。观察组并发症发生率显著低于对照组(P<0.05)。结论对于老年股骨粗隆间骨折的手术治疗,切口复位DHS内固定具有较高的成熟度,费用较少,是基层医院使用率较高的手术方式,闭合复位PFNA内固定复位与切开复位DHS内固定效果相当,但在术后并发症的控制方面效果更好,安全性更高。Objective To compare the efficacy of minimally invasive closed reduction proximal femoral nail antirotation(PFNA) internal fixation and open reduction dynamic hip screw(DHS) internal fixation in the elderly patients with intertrochanteric fractures.Methods A total of 100 elderly patients with intertrochanteric fractures admitted to the Second People’s Hospital of Lianyungang from January2015 to December 2017 were selected,and they were divided into observation group(n = 53) and control group(n = 53) according to the operation method.The observation group was treated with closed reduction PFNA internal fixation,while the control group was treated with open reduction DHS internal fixation.Various treatment indicators,excellent rate of treatment and complication rate of the two groups were evaluated and compared.Results There were no statistically significant differences in operation time,intraoperative blood loss and hospitalization time between the two groups(P > 0.05),while the operation cost of the observation group was higher than that of the control group(P<0.05).The excellent and good rate of treatment showed no significant difference between two groups(P > 0.05).The complication rate in the observation group was lower than that in the control group(P< 0.05).Conclusions For the surgical treatment of intertrochanteric fractures in the elderly,incision reduction and DHS internal fixation showed high maturity and less cost,which is easily carried out in the basiclevel hospitals.Closed reduction and reset PFNA internal fixation showe advantage in the postoperative complications.

关 键 词：老年人 股骨粗隆间骨折 螺旋刀片抗旋髓内钉 动力髋部螺钉 疗效 

分 类 号：R681.8[医药卫生—骨科学]