不同手术方案治疗股骨粗隆间骨折老年患者的效果对比

Different Surgery of the Treatment for Elderly Patients with Intertrochanteric Fractures

目的:对动力髋螺钉(DHS)、股骨近端抗旋髓内钉(PFNA)以及股骨近端锁定加压接骨板(PFLCP)对股骨粗隆间骨折老年患者的治疗效果进行比较分析。方法:对我院2011年2月至2013年12月收治并分别经动力髋螺钉(DHS)、股骨近端抗旋髓内钉(PFNA)以及股骨近端锁定加压接骨板(PFLCP)手术治疗的60例老年股骨粗隆间骨折患者进行回顾性分析,其中DHS组25例,PFNA组18例,PFLCP组17例,三组分别从手术一般情况、骨折愈合时间、术后并发症以及术后髋关节功能情况进行比较分析。结果:DHS组患者在手术时间、负重时间、住院时间以及并发症发生方面均较PFNA组和PFLCP组明显延长,且出血量较多,并发症发生率也较其余两组明显增加(P<0.05),而术后1个月随访PFNA组患者的Harris评分明显高于DHS组和PFLCP组(P<0.05),而术后3个月、6个月、12个月三组患者均无明显差异(P>0.05)。结论:PFNA和PFLCP相比DHS均具有恢复时间短、并发症少的优势,但PFNA术后患者在短期髋关节功能恢复方面具有显著优势,PFNA可作为治疗老年股骨粗隆间骨折的首选手术方式。

fracture healing time , postoperative complications , and postoperative hip function .Result：The surgery time , load time, length of hospital stay and complications of patients in the DHS group were significantly extended than those of the PFNA and PFLCP group , and the bleeding was more , the incidence of complications com-paring with the other two groups was significantly increased （P 〈0.05）, and the follow-up Harris scoring of the PFNA group after 1 month was obviously higher than that of the DHS group and the PFLCP group （ P 〈0.05） , and the Harris scoring of patients in three groups after surgery 3 months,6 months and 12 months were no obvious difference （P 〉0.05）.Conclusion：PFNA and PFLCP comparing with DHS have the ad -vantages of short recovery time and fewer complications , but PFNA has significant advantage of postoperative functional recovery in the short term , so we think that PENA should be as the preferred surgical procedure for elderly patients with intertrochanteric fractures .