股骨近端防旋髓内钉与动力髋螺钉对老年股骨转子间骨折患者围术期指标及术后并发症的影响  

Effects of proximal femoral nail antirotation and dynamic hip screw on perioperative indexes and postoperative complications in elderly patients with femoral intertrochanteric fracture

作　　者：董宏财 肖万军[1] 王臣[1] DONG Hongcai;XIAO Wanjun;WANG Chen(Department of Osteology,The Fourth People’s Hospital of Shenyang City,Liaoning,Shenyang 110031,China)

机构地区：[1]辽宁省沈阳市第四人民医院骨科,110031

出　　处：《河北医药》2020年第13期1953-1957,共5页Hebei Medical Journal

摘　　要：目的探究股骨近端防旋髓内钉(PFNA)及动力髋螺钉(DHS)对老年股骨转子间骨折患者围术期指标及术后并发症的影响。方法选择2015年1月至2018年12月收治的老年股骨转子间骨折患者纳入研究,其中行PFNA内固定治疗者65例,纳入PFNA组;行DHS内固定治疗者62例,纳入DHS组,比较2组患者围手术期指标及并发症发生情况,评价髋关节功能。结果PFNA组患者切口长度、术中出血量及手术时间小于DHS组(P<0.05);PFNA组患者下地时间及骨折愈合时间显著短于DHS组(P<0.05);术后1、3个月时PFNA组患者髋关节功能评分显著优于DHS组(P<0.05);术后6个月时2组患者髋关节功能差异无统计学意义(P>0.05);PFNA组及DHS组患者总并发症发生率分别为6.45%、9.23%,组间比较差异无统计学意义(P>0.05)。结论DHS、PFNA治疗老年股骨转子间骨折术后功能恢复效果相当,但PFNA内固定出血少、手术时间短、骨折愈合时间短。Objective To investigate the effects of proximal femoral nail antirotation(PFNA)and dynamic hip screw(DHS)on perioperative indexes and postoperative complications in elderly patients with femoral intertrochanteric fracture.Methods A total of 127 elderly patients with intertrochanteric fractures who were admitted and treated in our hospital from January 2015 to December 2018 were enrolled in the study,of whom,65 patients underwent PFNA internal fixation(PFNA group)and 62 patients underwent DHS internal fixation(DHS group).The perioperative indexes,the incidence of complications and hip joint function were observed and compared between the two groups.Results The length of incision,intraoperative blood loss and operation time in PFNA group were significantly shorter/less than those in DHS group(P<0.05).The ambulation time and fracture healing time in PFNA group were significantly shorter than those in DHS group(P<0.05).The hip function scores at 1m and 3m after operation in PFNA group were superior to those in DHS group(P<0.05).However there was no significant difference in hip function at 6 months after operation between the two groups(P>0.05).The total incidence rate of complications in PFNA group and DHS group was 6.45%and 9.23%,respectively,there was no significant difference between the two groups(P>0.05).Conclusion The effects of DHS and PFNA are similar in functional recovery of elderly patients with intertrochanteric fractures after operation.However,the blood loss by PFNA internal fixation is less,operation time and fracture healing time are shorter.

关 键 词：股骨近端防旋髓内钉 动力髋螺钉 股骨转子间骨折 

分 类 号：R683.421[医药卫生—骨科学]