锁定加压钢板与动力髋螺钉治疗股骨粗隆间骨折临床疗效比较

A comparative study of locking compresssion plate and dynamic hip screw in treatment of femoral intertrochanteric fratures

目的：比较锁定加压钢板（LCP）与动力髋螺钉（DHS）治疗股骨粗隆间骨折的临床疗效。方法：将我院及龙门县中医院于2008年11月至2010年2月收治的46例老年股骨粗隆间骨折的患者随机分为LCP组26例和DHS组20例，分别采用锁定加压钢板和动力髋螺钉治疗，随访6个月～2年。比较两组患者的出血量、手术时间、髋关节功能评分、骨折愈合时间、下肢缩短率、并发症发生率等。结果：两组患者的骨折愈合时间无显著性差异，P〉0．05。LCP组的Harris髋关节功能评分优20例，良4例，总优良率为92．3％（24／26），显著高于DHS组85．0％（17／20），P〈0．05。且LCP组在出血量、手术时间、下肢缩短率及并发症发生率方面显著优于DHS组，P〈0．05。结论：锁定加压钢板治疗股骨粗隆问骨折更符合生物力学，且出血量少，手术时间短，固定牢靠，并发症少，下肢缩短率低，是治疗股骨粗隆间骨折的较好方法。

Objective： To compare the therapeutic effect on femoral intertrochanteric fratures with locking compresssion plate（LCP） and dynamic hip screw （DHS）. Methods： 46 elderly patients with femoral intertrochanteric fratures in our hospital and LongMeng Traditional Chinese Medical hospital from November 2008 to February 2010 were randomly divided into two groups.One was treated with LCP （26 cases）.The other was treated with DHS （20 cases）. All patients were followed up for 6 months to 2 years.The blood loss,operative time,hip joint function,healing time, rate of lamb shorter and complications were eapared betweed two groups.Results： There were no significant difference in healing time between two groups,P〉0.05.The Harris Hip Jiont Fanction Scale was used to assess the jiont function. 20 cases were graded as good and 4 cases were graded as excerllent in LCP group. There were significant difference in the overall excellent and good rate between two groups （the LCP group reached 92.3%（24/26）,the DHS group reached 85.0%（17/20））, P〈0.05.The LCP group has more advantages in blood loss, operative time,rate of lamb shorter and complications compared with the DHS group.Conclusion： LCP is more consistent with biomechanics in treatment of femoral intertrochanteric fratures.And it has less blood lost,shorter operative time, more immobile and less complications compared with DHS.LCP is a recommended method in treatment of femoral intertrochanteric fratures.