动力髋部螺钉内固定和股骨近端髓内钉内固定治疗股骨粗隆间骨折的临床对照研究

The Clinical Controlled Study of Dynamic Hip Screw and Proximal Femoral Nail Fixation for Intertrochanteric Fracture

目的比较动力髋部螺钉(DHS)和股骨近端髓内钉(PFN)内固定治疗股骨粗隆间骨折的临床疗效。方法回顾性分析北京市潮白河骨伤科医院2002—2009年手术治疗股骨粗隆间骨折的164例患者临床资料并进行对照分析。按照手术方法将164例患者分为动力髋部螺钉内固定组(DHS组)和股骨近端髓内钉内固定组(PFN组)。结果 PFN组在手术时间、术中出血量、术后骨折愈合时间低于DHS组,差异均有显著性(P<0.05)。两组间切口愈合时间差异无显著性。DHS组术后髋关节功能优良率为84.4%,PFN组髋关节功能优良率为98.5%,差异有显著性(χ2=9.127,P<0.05)。DHS组有15例(15.6%)患者术后出现不同程度髋关节功能障碍,PFN组仅1例(1.5%),两组之间差异有显著性(χ2=12.25,P<0.05)。结论 DHS和PFN治疗股骨粗隆间骨折均有较好效果;采用PFN术,可减少手术时间、术中出血量和骨折愈合时间,且术后髋关节功能障碍发生率较低。

Objective To investigate the effect of Dynamic Hip Screw （DHS） and Proximal Femoral Nail Fixation （PFN） in treatment of intertrochanteric fracture. Methods Retrospective analysis was made on 164 patients who had intertrochanteric fracture and been treated with DHS and PFN in our hospital from 2002 to 2009. Results Operation time, blood loss and fracture healing time of the PFN group was significantly lower than those of DHS group （P〈0.05）; wound healing time between the two groups was no significant difference （P〉0.05）. Good rate of Hip joint function after surgery was 84.4% in the DHS group, and 98.5% in the PFN group （X2=9.127, P〈0.05）. Conclusion Both DHS and PFN in treatment of intertrochanteric fracture were satisfied, the use of PFN fixation can reduce the operative time, blood loss, and fracture healing time, lower rate of postoperative hip joint dysfunction.