DHS合并加压螺钉在股骨粗隆间骨折中应用的疗效分析

Effect of DHS and compression screw on femoral intertrochanteric fractures

[目的]探讨动力髋螺钉（dynamic hip screws，DHS）结合加压螺钉在股骨粗隆间骨折治疗中的疗效。[方法]对185例股骨粗隆间骨折行DHS、DHS＋加压螺钉、Ender钉、股骨近端解剖型钢板内固定治疗。术后记录手术持续时间、髋内翻发生率、Sanderg评分评定髋关节功能优良率。[结果]4组手术持续时间无明显差异。经术后9—48个月随访，髋关节功能康复优良率：DHS＋加压螺钉组94．6％、DHS组85．3％、Ender钉组75．4％、股骨近端解剖型钢板组80．6％。髋内翻发生率DHS＋加压螺钉组2．4％，DHS组9．5％，Ender钉组22．2％，股骨近端解剖型钢板组19．2％。[结论]4种内固定方式都可应用于股骨粗隆间骨折的手术治疗，但是DHS＋加压螺钉可最好地恢复髋关节功能和避免并发症的发生。

[Objective] To discuss the effects of DHS and compression screw application on femoral intertrochanteric fracture. [ Method] Internal fixation was performed with DHS, DHS and compression screw, Ender nail and proximal femoral anatomical plate in 185 patients with femoral intertrochanteric fracture. The main outcome measures were operation duration,coxa adducta rates and postoperative Sanders scoring. [ Result] All patients were followed up for 9 -48 months. Operation duration was similar in the four groups. There were significant differences in coxa adducta rates and postoperative Sander＇s scores. According to the Sander＇s scores,the excellent to good rates in DHS and compression screw, DHS,Ender nail and proximal femoral anatomical plate groups were 94.6% ,85.3% ,75.4% and 80.6% ,respectively. The coax adducta rates were 2.4% ,9.5% ,22.2% and 19.2% , respectively. [ Conclusion ] All the four kinds of internal fixation can be used for femoral intertrochanteric fracture, but DHS and compression screw is the best one for its good restoration of joint function and has no or little complication.