动力髋螺钉及3根空心螺钉两种内固定方式治疗中老年股骨颈基底型骨折临床疗效对比

Comparison of clinical efficacy between dynamic hip screw with three cannulated screws in treat ment of basicervical femoral neck fractures

目的比较动力髋螺钉(DHS)内固定方式及3根空心螺钉内固定方式治疗中老年(年龄≥55岁)新鲜的(骨折至手术时间≤3天)股骨颈基底型骨折的临床疗效。方法回顾性分析本院1999年至2009年10年间收住入院的中老年股骨颈基底型骨折的患者57人,其中采用动力髋螺钉内固定的有23例(DHS组),3根空心螺钉内固定的有34例(空心钉组)。两组患者均予以2年以上随访时间,比较两组患者手术时间、术中出血量、术后住院时间、术后至可下地负体重自主行走时间、术后1年优良率(Harris评分≥80分)、术后2年优良率、并发症发生率。结果 DHS组手术时间、术中出血量、术后住院时间均大于空心钉组(P<0.05);DHS组术后至可下地负体重行走时间小于空心钉组(P<0.05)。DHS组术后1年优良率、术后两年优良率均大于空心钉组(P<0.05)。DHS组术后并发症发生率小于空心钉组(P<0.05)。结论对于中老年新鲜的股骨颈基底型骨折,相比于3根空心螺钉固定,笔者更推荐动力髋螺钉内固定方式作为首选内固定方案。

Objective To compare the clinical efficacy between dynamic hip screw with three cannulated screws in treating fresh basicervical femoral neck fracture in aged patients. Methods Between 1999 and 2009, our hospital has treated 57 patients with basicervical femoral neck frac- tures. 23 patients were fixed with dynamic hip screw while the others were fixed with three cannulated screws. The operation time, blood lost, postop- erative hospital stay, the time till ability of walking alone, 1 year postoperative good rate, 2 years postoperative good rate, complication rate were com- pared. Results There were significant differences in the operation time, the blood lost, the Postoperative hospital stay, the time till ability of walking alone, 1 year postoperative good rate, 2 years postoperative good rate, complication rate between the DHS group and three cannulated screws group. Conclusion The DHS was optimal treatment in basicervical femoral neck fractures in aged patients.