PFNA与DHS治疗老年股骨粗隆间骨折的临床疗效对比研究

The Study of the Clinical Effect of the Aged Intertrochanteric Fracture between the PFNA and the DHS

目的:对比研究股骨近端抗旋转刀片髓内钉(proximal femoral nail antirotation,PFNA)与动力髋加压螺钉(dynamic hip screw,DHS)治疗老年股骨粗隆间骨折的临床疗效。方法:选取2010年4月-2012年7月于本院诊治的96例股骨粗隆间骨折并给予手术治疗的患者,根据手术方法不同分为PFNA组和DHS组,其中PFNA组58例,DHS组38例。分别对两组的患者术后临床疗效进行回顾性的分析与研究,术后临床疗效的评估采用Sander’s评分系统评价患者的髋关节及术后疗效。结果:PFNA组与DHS组治疗髋关节稳定型的股骨粗隆间骨折术后临床疗效优良率达到100%,术后疗效差异无统计学意义(P>0.05);对于不稳定的股骨粗隆间骨折,PFNA组的治疗疗效优于DHS组,两组比较差异有统计学意义(P<0.05)。结论:对于髋关节稳定的股骨粗隆间骨折,PFNA与DHS手术方式都能取得良好的临床效果,对于髋关节不稳定的股骨粗隆间骨折,特别是PFNA组在手术时间,手术失血量及术后恢复上优于DHS组。

Objective： To compare the clinical effect of proxiraal femoral nail anti-rotation （ PFNA ） and dynamic hip screw （ DHS ） on intertrochanteric fracture of femur. Method： Ninety-six patients with intertrochanteric fracture of femur admitted in author＇s hospital from April 2010 to July 2010 were treated by DHS （ DHS group, n=38 ） or PFNA （ PFNA, n=58 ） . The clinical effort was evaluated and studied with Sander＇s score system. Result： Both the PFNA group and DHS group obtained an excellent rate of 100% in the treatment of stable intertroehanteric fracture of femur. While regarding to the unstable intertrochanterie fracture of femur, the clinical effect of the PFNA group was better than the DHS group in a higher excellent rate percent, with a significant difference （ P〈0.05 ） . Conclusion： PFNA internal fixation is better than LCP and DHS fixation, with simple operation, less bleeding, solid fixation, and fewer complications.