股骨近端防旋髓内钉、动力髋螺钉治疗老年股骨粗隆间骨折的效果观察  

Curative effect of proximal femoral nail antirotation and dynamic hip screw on the elderly with intertrochanteric fracture

作　　者：徐立[1] 张淼[1] 张旭然[1] XU Li;ZHANG Miao;ZHANG Xuran(Department of Orthopedics,Fuxin Central Hospital,Fuxin,Liaoning,123000,China)

机构地区：[1]阜新市中心医院骨科,辽宁阜新123000

出　　处：《当代医学》2023年第10期146-149,共4页Contemporary Medicine

摘　　要：目的探讨股骨近端防旋髓内钉(PFNA)、动力髋螺钉(DHS)治疗老年股骨粗隆间骨折的临床疗效。方法选取2018年6月至2020年6月于本院接受手术治疗的70例老年股骨粗隆间骨折患者作为研究对象,按照随机数字表法分为PFNA组与DHS组,各35例。PFNA组采用PFNA进行内固定,DHS组采用DHS进行内固定,比较两组手术情况、髋关节功能评分与生活能力[Harris评分、日常生活活动能力(ADL)评分]、围手术期并发症发生情况。结果两组骨折愈合时间比较差异无统计学意义;PFNA组手术时间短于DHS组,术中出血量与术后引流量均少于DHS组,差异有统计学意义(P<0.05)。术前,两组Harris评分与ADL评分比较差异无统计学意义;术后6个月,两组Harris评分与ADL评分均高于术前,PFNA组Harris评分显著高于DHS组,差异有统计学意义(P<0.05);术后,两组ADL评分比较差异无统计学意义。PFNA组并发症发生率为5.71%,明显低于DHS组的22.86%,差异有统计学意义(P<0.05)。结论采用PFNA与DHS治疗老年股骨粗隆间骨折患者均可获得满意疗效,但PFNA具有手术操作简单快捷,出血量少,不良反应少,术后恢复好的特点,在临床应用中具有一定优势。Objective To investigate the clinical efficacy of proximal femoral nail antirotation and dynamic hip screw on the elderly with intertrochanteric fracture.Methods A total of 70 elderly patients with intertrochanteric fracture of femur who received surgical treatment in our hospital from June 2018 to June 2020 were selected as the study subjects,and they were divided into the PFNA group and the DHS group according to random number table method,with 35 cases in each group.the PFNA group was treated with PFNA for internal fixation,the DHS group was treated with DHS for internal fixation,the operation status,hip function score,living ability(Harris score,activity of daily living scale[ADL]score)and perioperative complications were compared between the two groups.Results There was no significant difference in fracture healing time between the two groups;the operative time in the PFNA group was shorter than in theDHS group,and the intraoperative blood loss and postoperative drainage volume were less than in the DHS group,the differences were statistically significant(P<0.05).Before operation,there was no significant difference between Harris score and ADL score between the two groups;6 months after operation,the Harris score and ADL score of two groups were higher than those before operation,and the Harris score in the PFNA group was significantly higher than that of in the DHS group,the difference was statistically significant(P<0.05),there was no significant difference in ADL scores between the two groups.The complication rate in the PFNA group was 5.71%,which was significantly lower than 22.86%in the DHS group,and the difference was statistically significant(P<0.05).Conclusion Both PFNA and DHS can achieve satisfactory efficacy in the treatment of elderly patients with intertrochanteric fracture of femur.However,PFNA has the characteristics of simple and rapid operation,less blood loss,less adverse reactions,and good postoperative recovery,which has certain advantages in clinical application.

关 键 词：老年股骨粗隆间骨折 股骨近端防旋髓内钉 动力髋螺钉 

分 类 号：R687.3[医药卫生—骨科学]