股骨近端交锁髓内钉与动力髁螺钉治疗老年不稳定型股骨粗隆间骨折的比较

Comparison Between Proximal Femoral Interlocking Nail and Dynamic Condylar Screw for the Treatment of Unstable Intertrochanteric Fracture in Elderly Patients

[目的]对比股骨近端交锁髓内钉（PFN）与动力髁螺钉（DCS）治疗老年不稳定型股骨粗隆间骨折的临床疗效.[方法]选取本院收治的老年不稳定型股骨粗隆间骨折患者43例,其中 22例采用股骨近端交锁髓内钉手术内固定治疗（PFN组）,21例采用动力髁螺钉手术内固定治疗（DCS组）.术后随访12～26个月,对两组患者的手术情况、术后髋关节功能及并发症情况进行统计分析.[结果]两组患者手术时间比较,差异无统计学意义（P〉0.05）.PFN组术中出血量和引流量均明显少于DCS组（P〈0.05）.术后随访,两组颈干角度数比较差异无统计学意义（P〉0.05）.术后1年PFN组Harris髋关节功能评分为（89.23±5.93）分,明显高于DCS组（84.09±9.38）分（P〈0.05）.两组术后并发症比较差异无统计学意义（P〉0.05）.[结论]股骨近端交锁髓内钉在术中出血量、术后引流量及术后功能恢复方面均优于动力髁螺钉,是治疗老年不稳定型股骨粗隆间骨折较理想的手术方式.

[Objective]To compare the clinical efficacy of proximal femoral interlocking nail（PFN） vs dynamic condylar screw（DCS） for the treatment of unstable intertrochanteric fracture in elderly patients. [Methods] Forty three patients with unstable intertrochanteric fracture admitted to our hospital were chosen. Among them, 22 pa tients（PFN group） underwent PFN internal fixation, and 21 patients（DCS group） underwent DCS internal fixa tion. All patients were followed up for 12-26 months. The operation state, hip joint function after operation and complications in two groups were analyzed statistically. [Results] There was no significant difference in the opera- tion time between two groups（ P〉0.05）. The intraoperative blood loss and drainage volume in PFN group were obviously less than those in DCS group（ P〈0.05）. During the follow up after operation, there was no significant difference in neck shaft angle between two groups（ P〉0.05）. Harris hip joint function score in PFN group at a year after operation was 89.23±5.93, which was obviously higher than that in DCS group（84.09 ± 9.38）（ P〈0.05）. There was no significant difference in the postoperative complications between two groups（ P 〉0.05）. [Conclusion] The intraoperative blood loss, postoperative drainage volume and functional recovery in PFN are bet ter than those in DCS, so it is an ideal procedure for the treatment of senile patients with unstable intertrochanteric fracture.