PFNA治疗高龄股骨粗隆间不稳定型骨折应用研究

目的:比较高龄股骨粗隆间不稳定型骨折的两种外科固定方法的临床疗效,即动力髋螺钉(DHS)和股骨近端防旋髓内钉(PFNA)。方法:收治60例高龄股骨粗隆间不稳定型骨折患者,随机分为两组,治疗组采用PFNA内固定治疗,对照组采用DHS内固定治疗。结果:两组手术时间、术中出血量和骨折愈合时间等情况比较有明显差异(P<0.05)。治疗后随访3个月,治疗组优良率为93.3%,对照组为73.3%,两组比较差异有显著性(P<0.05)。结论:PFNA是治疗高龄股骨粗隆间不稳定型骨折的理想选择,尤其适用于骨质疏松的粉碎骨折患者。

Objective： To compare effect of dynamic hip screw （ DHS ） and proximal femoral nail anti - rotation （ PFNA ） , two surgical fixation methods in treating unstable intertrochanter fracture of the femur in eld- erly patients. Methods：Sixty patients in our hospital from Aug. 2008 to Jan. 2012 were divided into Control Group and Treatment Group. Treatment Group were treated with PFNA; on the other hand, Control Group were treated with DHS. Result：Both groups showed significant differences （ P 〈 0.05 ） in operation time, intraoperative blood loss and fracture union time. In the follow - up visit for three months, Treatment Group had 16 excellent cases, 12 good cases ,2 average ca- ses and 0 poor cases, with the excellent and good up to 93.3% ;by comparison, Control Group covered 10 excellent cases, 12 good excellent cases, 5 average cases and 3 poor cases,with the excellent and good up to 73. 3 %. They showed a significant difference （P 〈 0. 05）. Conclusion： PFNA is an ideal treatment for unstable intertrochanter frac- ture of the femur in elderly patients, espe- cially fit for patients with comminuted frac-ture complicated by bone loss. , 1