PFN-A与DHS治疗不稳定性股骨粗隆间骨折疗效分析

Comparison analysis of the effect of PFNA and DHS in the treatment of unstable femoral intertrochanteric hip fracture

目的分析比较股骨近端防旋髓内钉(PFN-A)与动力髋螺钉(DHS)治疗不稳定性股骨粗隆间骨折的临床疗效。方法回顾性分析2007年1月～2009年3月手术治疗不稳定性股骨粗隆间骨折70例,PFN-A组40例,DHS组30例,对临床资料、手术方法、术后并发症和髋关节功能进行随访分析。结果所有患者均获随访,随访时间14～30个月,平均17个月。PFN-A组手术时间、术中出血量及术后并发症等均较DHS组少,术后髋关节功能评价按照Harris评分标准进行评定,PFN-A组优于DHS组。结论 PFN-A组具有明显的优势,操作简捷、微创,固定可靠,克服了DHS抗旋转能力差及股骨距区易产生应力集中,术后并发症多等不足,是治疗不稳定性股骨粗隆间骨折理想的内固定方法。

Objective To compare the clinical results of proximal femoral nail anti-rotation（PFNA） and dynamic hip screw（DHS） in the treatment of unstable femoral inter-trochanteric hip fracture.Methods Data of 70 cases of unstable inter-trochanteric hip fracture admitted into our hospital from Jan.2007 to Mar.2009 were retrospectively analyzed.Among the 70 patients,40 patients were treated by PFNA,30 patients by DHS.Follow-up was conducted for analyzing the clinical data,operation method,postoperative complication,and hip function.Results All patients were followed up for 14 to 30 months,with an average of 17 months.The operation time,intra-operative blood loss and postoperative complications in PFNA group were less than those of DHS group.Hip function was evaluated according to the Harris score system,indicating better function in PFNA group than in DHS group.Conclusion PFNA for treating unstable femoral inter-trochanteric hip fracture has obvious advantages,including simple manipulation,minimal invasiveness,reliable fixation and less postoperative complications.Also,PFNA overcomes the poor anti-rotation ability and is easy to produce stress concentration in the calcar femorale region.PFNA is ideal for treating unstable inter-trochanteric fracture.