股骨近端髓内钉与动力髋螺钉内固定修复老年股骨转子间骨折：12个月随访并发症发生率比较

Proximal femoral nail versus dynamic hip screw fixation for intertrochanteric fracture in the elderly: complication rate in 12-month follow-up

背景:有研究表明采用内固定治疗可以降低临床治疗股骨转子间骨折的并发症,改善患者的生活质量。其中被临床广泛应用的主要是股骨近端髓内钉和股骨近端髓内钉固定方法。目的:观察股骨近端髓内钉和动力髋螺钉内固定在治疗老年股骨转子间骨折的临床效果。方法:选择老年股骨转子间骨折患者60例,随机分为股骨近端髓内钉组和动力髋螺钉组2组,分别接受股骨近端髓内钉和动力髋螺钉固定治疗,每组30例。结果与结论:与动力髋螺钉组相比,股骨近端髓内钉组固定时间、固定时出血量、修复后12个月的并发症发生率、骨折愈合时间和并发症均降低(P<0.05),修复后髋关节功能Harris评分优良率升高(P<0.05)。两组的伤口愈合时间差异无显著性意义(P>0.05)。结果证实,与动力髋螺钉相比,采用股骨近端髓内钉内固定在治疗老年股骨转子骨折时的临床效果更好,安全可靠。

BACKGROUND：Internal fixation has been shown to decrease intertrochanteric fracture complications in the clinic and to improve quality of life of patients. The major method widely used in the clinic is the fixation of proximal femoral nail and dynamic hip screw. OBJECTIVE：To observe the clinical effects of proximal femoral nail and dynamic hip screw in treatment of intertrochanteric fracture in the elderly. METHODS：A total of 60 patients with intertrochanteric fracture were randomly divided into proximal femoral nail and dynamic hip screw groups （n=30）, and they respectively received proximal femoral nail and dynamic hip screw fixation. RESULTS AND CONCLUSION：Compared with the dynamic hip screw group, operative time, blood loss, the incidence of complications one year after repair, fracture healing time and complications were lower in the proximal femoral nail group （P〈0.05）. After repair, the excellent and good rate of Harris hip scores was higher （P〈0.05）. No significant difference was detected in healing time of wound between the two groups （P〉0.05）. Results verified that compared with the dynamic hip screw fixation, the clinical effects of proximal femoral nail fixation were better, more safe and reliable in the treatment of intertrochanteric fracture in the elderly.