DHS、PFNA、InterTan内固定三种术式对老年不稳定股骨粗隆间骨折的远期疗效比较  

Comparison of the long-term efficacy of DHS,PFNA and InterTan internal fixation in senile unstable intertrochanteric femoral fracture

作　　者：冯皓 余玲敏 王卫国 王建平 FENG Hao;YU Ling-min;WANG Wei-guo;WANG Jian-ping(Department of Orthopaedics,the People′s Hospital of Yingtan City,Jiangxi Province,Yingtan335000,China)

机构地区：[1]江西省鹰潭市人民医院骨科,江西鹰潭335000

出　　处：《中国当代医药》2020年第27期37-40,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(20204545)。

摘　　要：目的探讨动力髋螺钉(DHS)、股骨近端内固定系统(PFNA)、新型股骨近端髓内钉(InterTan)内固定对老年不稳定股骨粗隆间骨折(IFF)的远期疗效比较。方法选取2017年6月~2019年7月我院收治的90例老年不稳定IFF患者,依据双盲法分为A、B、C组,每组各30例,A组行DHS,B组行PFNA,C组行InterTan内固定治疗。比较三组患者的手术指标(手术用时、切口长度、术中出血量、骨折愈合时间);术后随访半年,比较三组患者的髋关节功能(以Harris评分评定)与不良反应发生情况。结果B组患者的手术用时和骨折愈合时间短于A、C组,切口长度短于A、C组,术中出血量少于A、C组,差异均有统计学意义(P<0.05);C组患者的手术用时和骨折愈合时间短于A组,切口长度短于A组,术中出血量少于A组,差异均有统计学意义(P<0.05)。三组患者术前的Harris评分比较,差异无统计学意义(P>0.05);术后半年,三组患者的Harris评分均高于术前,差异有统计学意义(P<0.05);术后半年,C组患者的Harris评分高于A、B组,差异有统计学意义(P<0.05);术后半年,B组患者的Harris评分高于A组,差异有统计学意义(P<0.05)。B、C组患者的不良反应总发生率均低于A组,差异有统计学意义(P<0.05),B组患者的不良反应总发生率与C组比较,差异无统计学意义(P>0.05)。结论老年不稳定IFF患者采用PFNA治疗的效果更佳,可有效提升髋关节功能并降低术后不良反应总发生率,是较佳的治疗方式,值得临床推广应用。Objective To investigate the long-term efficacy of dynamic hip screw(DHS),proximal femoral nail antirotation(PFNA)and new proximal femoral intramedullary nail(InterTan)internal fixation in senile unstable intertrochanteric femoral fracture(IFF).Methods A total of 90 senile patients with unstable IFF admitted in our hospital from June 2017 to July 2019 were selected as the research subjects and divided into groups A,B and C according to double blind method,with 30 cases in each group.Group A was treated with DHS,group B was treated with PFNA,and group C was treated with InterTan internal fixation.The surgical indexes(operation time,length of incision,intraoperative bleeding volume,fracture healing time)were compared among the three groups.The hip joint function(evaluated by Harris score)and the incidence of adverse reactions were compared among the three groups after six months of postoperative follow-up.Results The operation time and fracture healing time of group B were shorter than those of group A and C,the incision length was shorter than that of group A and C,the intraoperative blood loss was less than that of group A and C,and the differences were statistically significant(P<0.05).The operation time and fracture healing time of group C were shorter than those of group A,the incision length was shorter than that of group A,the intraoperative blood loss was less than that of group A,and the differences were statistically significant(P<0.05).There were no statistically significant differences in Harris scores before operation among the three groups(P>0.05).The Harris scores of the three groups after six months of operation in all three groups were higher than those before operation,and the differences were statistically significant(P<0.05).The Harris score of group C was higher than that in the group A and B,and the difference was statistically significant(P<0.05).The Harris scores of group B was higher than that of group A,and the difference was statistically significant(P<0.05).The total incidence of adverse

关 键 词：不稳定股骨粗隆间骨折 动力髋螺钉 股骨近端内固定系统 新型股骨近端髓内钉 

分 类 号：R683.42[医药卫生—骨科学]