股骨近端锁定钢板与动力髋螺钉治疗转子间骨折的分析

Treatment of intertrochanteric fracture by proximal femoral locking plate or dynamic hip screw

目的比较股骨近端锁定钢板与动力髋螺钉(DHS)治疗股骨转子间骨折的临床效果。方法收集2007年6月～2010年12月来我院就诊的股骨转子间骨折的患者87例,随机分成两组,分别采用股骨近端锁定钢板(47例)和DHS(40例)治疗,比较两组患者的手术时间、术中出血、骨折愈合时间、髋关节功能Harris评分及术后并发症。结果 87例患者均获得随访,平均随访时间为11.6个月。两组患者在手术时间上无明显差异(P>0.05),但近端锁定钢板组术中出血多于DHS组(P<0.01);两组患者骨折愈合时间及Harris评分无统计学差异(P>0.05);近端锁定钢板组出现2例锁定螺钉进入髋关节的并发症,DHS组出现1例髋内翻、1例头钉拔出。结论股骨近端锁定钢板治疗转子间骨折临床效果与DHS相似,是一种较为理想的手术方式。

Objective To make the comparison of clinical effects between proximal femoral locking plate and dynamic hip screw（DHS） in the treatment of intertrochanteric fracture.Methods From June 2007 to December 2010,87 patients with intertrochanteric fracture were treated in our hospital.They were randomly divided into two groups and received the treatment by proximal femoral locking plate（47 cases） or DHS（40 cases）,respectively.Comparison was made in the operation time,blood loss during the operation,healing time,Harris score,and postoperative complications between the two groups.Results All these patients were followed up with the average time of 11.6 months.There was no significant difference in operation time between the two groups（P0.05）.But the blood loss during the operation in patients receiving the proximal femoral locking plate was significantly higher than that in those receiving DHS（P0.01）.There was no significant difference in healing time and Harris scores between the two groups（P0.05）.Among the patients receiving proximal femoral locking plate,the complication of screw coming into hip joint occurred in one case.Among those receiving DHS,coxa vara and extraction of the screw did in one,respectively.Conclusion The clinical effect of treatment by proximal femoral locking plate is similar to that by DHS.This treatment is also a desirable surgical method.