PFNA和DHS治疗老年性股骨粗隆间骨折的临床对照研究

Clinical Comparison of PFNA with DHS for Femoral Intertrochanteric Fractures in Elder

目的:探讨PFNA和DHS治疗老年性股骨粗隆间骨折的临床疗效。方法:回顾分析2010年3月至2011年6月间69例行手术治疗的老年性股骨粗隆间骨折的临床资料,其中股骨近端抗旋髓内钉(PFNA)37例(PFNA组),动力髋螺钉(DHS)32例(DHS组);比较两组平均手术时间、术中出血量、术后并发症、治疗费用、骨折愈合时间和髋关节功能。结果:PFNA组平均手术时间和术中出血量均低于DHS组(P<0.05);术后并发症差别无统计学意义(P>0.05);PFNA组治疗费用高于DHS组(P<0.05);术后随访时间11-20个月,两组病例均临床愈合,PFNA组优良率高于DHS组(P<0.05)。结论:PFNA与DHS均是治疗老年性股骨粗隆间骨折的较好材料,PFNA更符合生物学特点,具有手术创伤小、固定牢靠、恢复好的优点,但治疗费用较高,临床应用可根据患者病情和经济状况选用。

Objective： To investigate the clinical effect of femoral intertrochanteric fractures in elder treated by Proximal Femoral Nail-A（PFNA） or Dynamic Hip Screw（DHS）.Methods： The clinical data of 69 patients with femoral intertrochanteric fractures in elder treated by PFNA or DHS between March 2010 and June 2011 were analyzed.Among them,37 cases treated by PFNA（PFNA group）,and 32 cases treated by DHS（DHS group）.Clinical parameters including operative time,blood loss during operating,complications,treatment costs,fracture healing and the score of Hip Joint were compared.Results： The operative time and blood loss in PFNA group were lower than those in DHS group（P 0.05）.No significant difference was observed in postoperative complications between two groups（P 0.05）.The treatment costs in PFNA group were higher than that in DHS group（P 0.05）.All patients were followed up 11 to 20 months and achieved bone healing（P 0.05）.And the score of Hip Joint in PFNA group were higher than that in DHS group（P 0.05）.Conclusions： PFNA and DHS are good selection for treating femoral intertrochanteric fractures in elder patients.PFNA possesses lowertraumaandfixationwell,butexpensive.Theapplicationshouldbeselectedaccordingtothepatient＇sinjuriesandeconomiccondition.