动力髋螺钉与股骨近端髓内钉治疗老年股骨粗隆间骨折的疗效比较

Comparison of curative effect of dynamic hip screw and proximal femoral nail in the treatment of intertrochanteric fractures in elderly patients

目的观察和比较动力髋螺钉(DHS)和股骨近端髓内钉(PFN)治疗老年股骨粗隆间骨折的临床疗效。方法选取98例老年股骨粗隆间骨折患者采用信封法随机分为两组,各49例,分别采用DHS内固定(DHS组)及PFN内固定治疗(PFN组),比较两组患者手术情况(手术时间、术中出血量、切口长度)、并发症发生情况及骨折愈合时间。采用Harris法对两组患者髋关节功能进行评定。结果 PFN组髋关节功能优良率为87.76%,DHS组为71.43%,差异有统计学意义(P<0.05)。PFN组骨折愈合时间为(9.8±1.5)周、切口长度为(8.9±1.5)cm、手术时间为(90.5±12.5)min、术中出血量为(180.2±87.5)mL,DHS组骨折愈合时间为(12.8±2.5)周、切口长度为(5.2±0.8)cm、手术时间为(100.5±15.6)min、术中出血量为(275.6±80.5)mL,差异有统计学意义(P<0.05)。PFN组并发症发生率为14.29%,DHS组为2.04%,差异有统计学意义(P<0.05)。结论对老年股骨粗隆间骨折患者采用PFN治疗时,疗效优于DHS,并发症少。

Objective To observe and compare the curative effect of dynamic hip screw （DHS） and proximal femoral nail （PFN ） in the treatment of elderly intertrochanteric fracture .Methods A total of 98 cases of elderly pa-tients with intertrochanteric fracture were randomly divided into two groups ,with 49 cases for each group .DHS fixa-tion （DHS group） and PFN fixation （PFN group） were performed ,and surgical information （operative time ,blood loss ,incision length） ,the incidence of complications and healing time were compared between the two groups .Harris method was used to evaluate hip joint function .Results Fineness rate of hip joint in PFN group was 87 .76% ,which was significantly different with the 71 .43% of DHS group （P〈0 .05） .Healing time ,incision length ,operative time and blood loss of PFN group were （9 .8 ± 1 .5） weeks ,（8 .9 ± 1 .5）cm ,（90 .5 ± 12 .5）min and （180 .2 ± 87 .5）mL , which were lower than the （12 .8 ± 2 .5） weeks ,（5 .2 ± 0 .8）cm ,（100 .5 ± 15 .6）min and （275 .6 ± 80 .5）mL of DHS group （P〈0 .05） .The incidence rate of complications in PFN group was 14 .29% ,higher than the 2 .04% in DHS group （P〈0 .05） .Conclusion Curative effect of PFN for the treatment of intertrochanteric fractures could be supe-rior to DHS ,and be with less complications .