老年不稳定股骨粗隆间骨折不同内固定手术疗效比较

Comparative analysis of clinical effect of DHS and PFNA for the treatment of senile patients with unstable femoral intertrochanteric fractures

目的比较动力髋螺钉(DHS)和股骨近端防旋髓内钉(PFNA)在治疗老年不稳定股骨粗隆间骨折中的疗效。方法分析61例65岁以上老年不稳定股骨粗隆间骨折应用DHS(32例)和PFNA(29例)内固定的疗效,比较两组手术时间、手术前后血红蛋白量、术后下地负重时间及髋关节功能Harris评分等指标。结果 61例围手术期均没有严重并发症发生。PFNA组手术时间、术后下地负重时间较DHS组短,术后失血量更少,差异有统计学意义(P<0.05);PFNA组Harris评分优良率(93.1%)明显高于DHS组(71.9%),差异有统计学意义(P<0.05)。结论老年不稳定股骨粗隆间骨折采用PFNA内固定疗效较好,具有操作简单、出血少、内固定可靠、允许早期功能锻炼等优点。

Objective To compare the clinical effects of DHS and PFNA in the treatment of femoral intertrochanteric fractures in elderly patients with unstable femoral intertrochanteric fractures. Methods Retrospective analysis was performed in 61 cases of senile femoral intertrochanteric fractures. Totally 32 cases received DHS fixation and 29 PFNA fixation. The operation time,hemoglobin at perioperative period, weight bearing time and the Harris hip function scores were observed. Results No serious complications occurred in either group at perioperative period. The operation time, blood loss, and weight bearing time of PFNA group was significantly less than those of DHS group（P 〈0.05）. The Harris hip score of PFNA group was higher than t hat of DHS group（P 〈0.05）. The excellent and good rate （93.1%） in PFNA group was superior to that（71.9%） in DHS group （P 〈0.05）. Conclusion PFNA can be recommended to the treatment of unstable femoral intertrochanteric fractures in the senile patients for its advantages of simple operation, less bleeding, reliable fixation, and early functional exercise allowed.