两种内固定方法治疗老年骨质疏松性股骨转子间骨折疗效比较

The efficacy comparison of two internal fixation methods in the treatment of elderly osteoporotic intertrochanteric fractures

目的探讨两种内固定方法治疗老年骨质疏松性股骨转子间骨折的临床疗效。方法 60例老年骨质疏松性股骨转子间骨折患者根据随机数字法分为动力髋螺钉（DHS）组及股骨近端髓内钉（PFN）组,每组30例,记录两组手术时间、术中出血量、住院时间,以Harris评分标准评定疗效。结果 PFN组手术时间、术中出血量、住院时间均短（少）于DHS组,差异均有统计学意义（P〈0.05）。患者均获随访,时间6～15个月。术后3个月髋关节功能Harris评分：PNF组（89.0±6.0）分,DHS组（84.0±5.0）分,差异有统计学意义（P〈0.01）。PFN组患者下床活动时间、生活自理时间、恢复工作时间、骨折愈合时间均短于DHS组,差异均有统计学意义（P〈0.05、P〈0.01）。结论对于老年骨质疏松性股骨转子间骨折患者,采用PFN内固定较DHS效果好。

Objective To investigate the clinical efficacy of the two internal methods of internal fixation in elderly osteoporotic intertrochanteric fractures. Methods 60 cases with osteoporotic intertrochanteric fractures were divided into dynamic hip screw（ DHS,n = 30） group and the proximal femoral nail（ PFN,n = 30） group. The mean operating time,blood loss,hospital stay were recorded,and Harris scoring criteria of two groups were evaluated. Results The operative time,blood loss,hospital stay was significantly shorter in PFN group than DHS group（ P〈0. 05）. All cases were followed up for 6 ～ 15 months. Three months after surgery Harris hip score： PNF group was（ 89. 0 ± 6. 0）points; DHS group was（ 84. 0 ± 5. 0） points,the difference was statistically significant（ P〈0. 01）. Patients ambulation,self-care time,return to work time,healing time were significantly shorter in the PFN group than DHS group,the difference was statistically significant（ P〈0. 05,P〈0. 01）. Conclusions For patients with osteoporotic intertrochanteric fracture,fixation using PFN provides better results than DHS.