髋关节动力螺钉和股骨近端髓内钉-螺旋刀片固定股骨转子间骨折的效果比较

Therapeutic effect of dynamic hip screw versus proximal femoral nail anti-rotation blade for intertrochanteric fractures

背景:髋关节动力螺钉是临床固定股骨转子间骨折的金标准,取得了一定的疗效,而股骨近端髓内钉-螺旋刀片是经过改进的新型股骨近端髓内固定系统,它的运用解决了以往内固定的不足。目的:比较髋关节动力螺钉和股骨近端髓内钉-螺旋刀片治疗股骨转子间骨折的疗效。方法:76例股骨转子间骨折患者,其中36例用髋关节动力螺钉固定,40例用股骨近端髓内钉-螺旋刀片固定,均采用常规手术入路。结果与结论:股骨近端髓内钉-螺旋刀片组的髋部畸形率及并发症发生率均低于髋关节动力螺钉组(P<0.05),髋关节动力螺钉组髋关节功能恢复优良率达78%(28/36),股骨近端髓内钉-螺旋刀片组为82%(33/40)。结果可见两组治疗股骨转子间骨折均有满意的临床疗效,但是股骨近端髓内钉-螺旋刀片固定组具有操作简单、固定牢靠的优点。

BACKGROUND： Dynamic hip screw （DHS） is the gold standard for clinical fixation of intertrechanteric fractures, and achieves certain effect. But proximal femoral nail anti-rotation （PFNA） blade is a new modified proximal femoral fixation system, which is used to solve the deficiencies of previous fixation. OBJECTIVE： To compare the clinical effect of DHS and PFNA blade for intertrochanteric fractures METHODS： Totally 76 patients with intertrochanteric fractures were selected including 36 cases treated with DHS and 40 cases with PFNA. All the patients received operative treatment with common operative route. RESULTS AND CONCLUSION： Incidence rate of medical complication and deformity rate of hip joint in the PFNA group were lower than those in the DSH group （P 〈 0.05）. The excellent and good rate of the hip function recovery was 78% （28/36） in the DSH group, and which in the PFNA group was 82% （33/40）. The results showed that both the two method of DHS and PFNA have good clinic curative effect for the treatment of intertrochanteric fractures, but the PFNA has the advantages of simple operation, less bleeding, and reliable fixation.