螺旋刀片抗旋髓内钉在股骨转子间不稳定性 骨折中的应用

Effect of Proximal Femoral Nail Anti -rotation for Unstable Intertrochanteric Fracture of Femur

目的：比较螺旋刀片抗旋髓内钉（PFNA）和动力髋螺钉（DHS）技术治疗股骨转子间不稳定性骨折的临床效果.方法：选择2012年6月～2016年6月入我院诊断股骨转子间不稳定性骨折患者共170例,其中PFNA术90例和DHS术80例,平均随访30.5±9.3个月,分析临床基线资料、手术效果和并发症.结果：2组患者的性别、年龄、骨折分型和骨折时间具有可比性（P〉0.05）.2组的内固定物个数、长度,手术时间、术中出血量、术后联合用药种类、辅助外固定物的应用时间及术后下地负重时间比较,差异有统计学意义（P〈0.05）;PFNA术组术后临床愈合率显著高于DHS术组,并发症发生率显著降低,随访Harris髋关节功能评分优良率显著高于DHS术组,差异有统计学意义（P〈0.05）.结论：在严格把握手术适应证的前提下,PFNA较DHS术治疗股骨转子间不稳定性骨折有较好的临床效果和远期预后.

Objective：To study the clinical effect of proximal femoral nail anti -rotation （PFNA）and dynamic hip screw （DHS） for un- stable intertrochanteric fracture of femur, nethods：A total of 170 eonsecutives from June 2012 to June 2016 were enrolled ,90 patients of which received PFNA and other 80 patients adopted DHS, the mean follow - up time was （ 30. 5 ± 9.3 ） months, then to compare the effects. Results： The gender, age, types and days of fracture in the two groups were no statistical differences （ P 〉 0. 05 ） o The number, length of internal fixation, operation time, blood loss during operation, drugs usage after operation, days of auxiliary external fLxator and start？ time？ of？ postoperative？ weight -bearing？ exercise in the two groups were statistical differences （P 〈 0. 05 ） ; the clinical curing rate in PFNA group was significantly more, complications rate was lower, the excellent rate of Harri hip function score was higher than DHS group（P 〈 0. 05 ） o Conclusion： It is better of PFNA than DHS for unstable intertroch/mteric fracture of femur at the condition of strictly grasping indications of operation.