动力髋螺钉和股骨近端髓内钉治疗老年股骨转子间骨折的比较

Comparative analysis of dynamic hip screw and proximal femoral nail in treatment of elderly patients with intertrochanteric fractures

目的比较采用动力髋螺钉(DHS)和股骨近端髓内钉(PFN)治疗老年股骨转子间骨折的术中情况、术后并发症及疗效。方法 2004年1月至2009年10月,分别采用DHS(DHS组,32例)和PFN(PFN组,25例)治疗并随访老年股骨转子间骨折患者57例。比较两组患者手术情况、术后并发症及功能恢复情况。结果 PFN与DHS相比较在切口长度、手术时间、术中出血量、术后引流量及骨折临床愈合时间等方面比较差异有统计学意义(P均<0.01)。与DHS组相比,PFN组手术切口小、手术时间短、术中出血量及术后引流量少、骨折临床愈合时间短。DHS组和PFN组的优良率分别为84.38%和88.00%,两组间疗效差异无统计学意义(P>0.05)。结论应用DHS和PFN治疗老年股骨转子间骨折,在疗效方面比较差异无统计学意义。PFN可缩短手术时间、减少术中出血量及术后并发症。

Objective To compare the operative procedures, postoperative complications and effects of dynamic hip screw （DHS） and proximal femoral nail（PFN） in the treatment of elderly patients with intertrochanteric fractures. Methods From January 2004 to October 2009, 57 elderly patients with intertrochanteric fractures were treated with DHS（ DHS group,32 cases） or PFN（ PFN group, 25 cases） and were followed up. The operative procedures, postperative complications and functional resto- ration of the two groups were compared. Results There were significant differences in the mean operation time, length of inci- sion, intraoperative blood loss, postoperative drainage and union time of fracture between DHS group and PFN groups （P 〈 0. O1 ）. The PFN group had less operation time, smaller incision, less blood loss and drainage and less union time than DHS group. However, the excellent rate was 84. 38% in DHS group and 88.00% in PFN group, there was no sighificant difl~：rence between the two groups （ P 〉 O. 05 ）. Conclusion There is no significant difference in the therapeutic effect between DHS group and PPN group. PFN may shorten the mean operation time, the mean intraoperative blood loss and reduce the complications.