PFNA与DHS治疗老年性股骨粗隆间骨折疗效对比

Comparison of efficacy of PFNA and DHS in the treatment of senile femoral intertrochanteric fracture

目的 比较股骨近端防旋髓内钉（proximal femoral nail antirotation,PFNA）与动力髋加压螺钉（dynamic hip screw,DHS）两种内固定方式治疗老年股骨粗隆间骨折的效果.方法 选取2011年7月～2013年7月手术治疗的196例股骨粗隆间骨折患者,随机分为两组,应用股骨近端防旋髓内钉治疗（PFNA组）105例,应用动力髋螺钉内固定方式治疗（DHS组）91例.比效两组平均手术时间、术中出血量、骨折愈合时间、髋关节Harris评分和术后并发症.结果 PFNA组平均手术时间、术中出血量及骨折愈合时间均显著低于DHS组,差异有统计学意义（P＜0.001）,而髋关节功能恢复情况差异无统计学意义（P＞0.05）.结论 PFNA治疗老年股骨粗隆间骨折具有术程短、出血少、术后恢复快等优点,明显优于DHS,是治疗老年股骨粗隆间骨折的理想选择.

Objective To compare the effect of proximal femoral nail antirotation（PFNA） and dynamic hip screw（DHS） in the treatment of senile femoral intertrochanteric fracture.Methods 196 cases with femoral intertrochanteric fracture underwent surgical treatment from July, 2011 to July, 2013 were randomly divided into PFNA group（ treated with PFNA）and DHS group （treated with DHS internal fixation） with 105 cases in the former group and 91 cases in the latter group.Then, the operation time, amount of blood during operation, fracture healing time, Harris scores of hip joint and postoperative complications of two groups were compared. Results The average operation time, the amount of blood during operation and fracture healing time of the PFNA group were significantly lower than those of the DHS group,which showed statistically significant difference （P〈0. 001 ）.No statistical significance was found in the recovery of hip joint function between two groups（ P〉O. 05）.Conclusion PFNA has advantages of short surgical process,less amount of blood and rapid postoperative recovery in the treatment of senile femoral intertrochanteric fracture.It is obviously superior to DHS.Thus ,PFNA is an ideal choice to treat senile femoral intertrochanteric fracture.