DHS、LPFP、PFN和PFNA治疗老年股骨粗隆间骨折临床分析

Clinical Analysis of DHS,LPFP,PFN and PFNA on Intertrochanteric Hip Fractures in Elderly Osteoporosis Patients

目的采用动力髋螺钉(DHS)、股骨近端锁定钢板(LPFP)、股骨近端带锁髓内钉(PFN)和防旋型股骨近端髓内钉(PFNA)治疗老年股骨粗隆间骨折,对比分析其治疗效果。方法对139例老年股骨粗隆间骨折,分别采用DHS、LPFP、PFN、PFNA进行治疗,从手术时间、术中出血量、骨折愈合时间、术后并发症、术后髋关节功能评分等方面进行分析比较。结果在出血量和手术时间上,PFNA组与其他组之间差异有统计学意义。各组间内固定物松动及并发症总发生率差异有统计学意义,疗效及平均愈合时间差异无统计学意义。结论 PFNA组术中出血量及手术时间明显较其他组少,DHS组内固定物松动率、并发症总发生率明显高于其他各组。

Objective To study the significance of internal fixations of intertrochanteric hip fractures in elder patients by comparing the effects of various kinds of internal fLxations. Methods One hundred and thirty nine elder patients with intertrochanteric hip fractures were followed up. They were treated with the four kinds of operations respectively： dynamic hip screw （DHS）, locking proximal femur plate （LPFP）, proximal femoral nail （PFN） and proximal femoral nail antirotation （PFNA）. The data of each group were collected for statistical analysis on the following aspects： operative time, blood loss, clinical healing time of fractures, posteroperative complications and functional outcome. Results The differences of the operative time and blood loss between group PFNA and other groups were statistically signifi- cant. There were significant differences in the rate of loosening of internal fixation and the total rate of complications. No differences of functional outcome and clinical healing time of fractures in four groups were found. Conclusion Group PFNA has shorter operative time and less blood loss than other groups. Group DHS has higher rate of loosening of internal fixation and the complications.