DHS、PFNA治疗股骨转子间骨折的临床疗效对比性研究

Comparative study on the clinical effect of DHS,PFNA for treatment of intertrochanteric fractures

目的对DHS、PFNA治疗股骨转子间骨折的手术创伤、并发症及临床疗效进行比较。方法回顾性分析2007年1月～2010年5月收治的股骨转子间骨折患者61例,其中DHS固定治疗30例,PFNA组31例。详细记录手术时间、术中出血量、术中术后并发症发生率、骨折愈合时间和术后髋关节功能恢复程度,进行分析比较。结果 61例患者术后随访5～41个月,平均20.5个月。髋关节功能按Harris评分标准。与DHS组相比,PFNA组切口小,术中出血量少,骨折临床愈合时间短,且可早期下床负重而更少术中术后并发症发生率。术后髋关节早期活动功能恢复情况PFNA组明显优于DHS组,而远期的髋关节活动功能恢复情况两组之间无明显差异。结论 PFNA组术中出血量明显减少、对患者损伤小,对各型骨折都能提供牢靠固定、术中术后并发症发生率低,是治疗股骨转子间骨折理想的手术方法。

Objective To compare surgical trauma,complications and the clinical curative effects of DHS,PFNA for treatment of intertrochanteric fractures of femur.Methods 61 cases of intertrochanteric fractures of femur admitted from January 2007 to May 2010 were reviewed.30 patients were treated by DHS,while 31 cases were treated by PFNA.Analytic comparisons were then conducted to study the difference between the two kinds of internal fixations,including operation time,blood loss during operation, the incidence of complications of intraoperation or postoperation,bony union time and the function changes of hip joint.Results After operation,61 cases were followed up from 5 to 41 months with 20. 5 months on the average.The function of the hip joint was evaluated with the Harris hip score.PFNA was implanted with a significantly smaller incision and shorter clinical healing time,less blood loss.The PFNA group had an earlier weight—bearing with a fewer rate of complication.The function changes of the hip joint of the PFNA group were better than the DHS group.There was no obvious difference in the function changes of the hip joint in the long—term between the two groups.Conclusions The PFNA can shorten the blood loss of intraoperation,be little trauma for the patients,supply firm fixation for all fracture types,reduce the incidence of complications intraoperation and postoperation.The PFNA was an ideal implant for treatment intertrochanteric fractures.