可膨胀股骨近端钉和DHS治疗股骨转子间骨折疗效比较

The effect comparison of the fixion expandable proximal femoral nail and DHS in treating intertrochanteric femoral fractures.

目的比较可膨胀股骨近端钉和DHS在治疗股骨转子间骨折中的优缺点,探讨股骨转子间骨折内固定选择的策略。方法总结自1997年5月至2006年11月在浙江省人民医院骨科接受股骨转子间骨折可膨胀股骨近端钉和DHS固定手术病例总计223例。DHS(Dynamic Hip Screw)固定组(DHSA组)165例,可膨胀股骨近端钉组(Proximal Femoral Nail PFN,B组)58例。比较两组在手术时间、术中出血量、术中X线暴露次数、术后引流量、骨折临床愈合时间、术后功能评分、手术并发症等方面的结果。结果A组和B组在手术时间、术中出血量、术中X线暴露次数、术后引流量、骨折临床愈合时间、术后功能评分等方面等方面差异有统计学意义(P<0.01),B组较A组手术时间缩短、术中出血量和术后引流量减少、骨折临床愈合时间缩短、术后功能恢复改善,但术中X线暴露次数明显增加。两组手术并发症的差异有统计学意义(P<0.05)。结论:可膨胀股骨近端钉在治疗股骨转子间骨折中具有一定的优势。

Objective To compare the effect of the Fixion expandable proximal femoral nail and DHS in treating intertrochanteric femoral fractures. Methods From May 1997 to November 2006, 165 cases were treated with the dynamic hip screws(DHS group A), 58 cases were treated with the Fixion expandable proximal femoral nails(PFN group B) in Zhejiang Provincial People's Hospital. The data of each group were collected for statistical analysis on the following aspects: operation time, blood loss, X-ray exposures, drainage, clinical healing time of fractures, post operative restored function and the total complications. Results The difference of operation time, blood loss, X-ray exposures, drainage, clinical healing time of fractures, post operative restored function were of statistical significance(P<0.01). In comparing with group A, group B was of less operation time, blood loss , drainage, clinical healing time of fractures, but more X-ray exposures, and the post operative restored function of group B was more satisfying. The difference of operative complications were of statistical significance (P<0.05), group B was of less operative complications. Conclusion The Fixion expandable proximal femoral nail is a good choice for intertrochanteric femoral fractures.