两种内固定术治疗老年股骨粗隆间不稳定性骨折的疗效

Effects of two different methods in the treatment of unstable intertrochanteric fractures in elderly patients

目的比较抗旋髓内钉(PFNA)与动力髋螺钉(DHS)内固定术治疗老年股骨粗隆间骨折的临床疗效及对髋关节功能的影响。方法根据随机数字表法将80例股骨粗隆间骨折患者分为观察组和对照组,观察组采用PFNA内固定术治疗,对照组采用DHS内固定术治疗。比较两组患者手术情况、骨折愈合情况及髋关节功能。结果 (1)观察组患者手术时间短于对照组,出血量少于对照组,差异有统计学意义(t=2.890、2.922,P<0.05);(2)观察组功能、疼痛、畸形、运动范围及总分均显著高于对照组,差异有统计学意义(P<0.05);观察组患者术后髋关节功能优良率为90.0%,对照组为72.5%,观察组高于对照组,差异有统计学意义(χ2=4.021,P<0.05)。结论股骨近端PFNA内固定术治疗老年股骨粗隆间骨折手术时间短,出血量少,术后髋关节功能恢复好,值得临床推广应用。

Objective To compare the clinical effects of proximal femoral nail anti-rotation（PFNA）and dynamic hip screw（DHS）fixation in the treatment of unstable intertrochanteric fractures in elderly patient and their impacts on hip joint function.Methods A total of 80patients with intertrochanteric fractures were divided into observation group and control group according to random number table.Patients in observation group were treated with PFNA fixation,and patients in control group were treated with DHS fixation.Surgical situation,healing of fracture and hip joint function of the two groups were compared.Results（1）The operative time and bleeding volume of observation group was less than control group（t=2.890and 2.922,P0.05）.（2）The function,pain,deformity,range of motion and total scores of observation group were significantly higher than control group（P〈0.05）.Of observation group,the postoperative hip joint function excellent rate was 90.0%,significantly higher than the 72.5%of control group（χ2=4.021,P〈0.05）.Conclusion The treatment of PFNA fixation in intertrochanteric factures in elderly patents might be with advantages of shorter operative time,less blood loss,and fine recovery of postoperative hip joint function,which could be worthy of promotion.