动力髋螺钉和锁定钢板内固定治疗股骨转子间骨折的疗效分析

Efficacy analysis on the curative effect of dynamic hip screw and locking plate fixation in the treatment of intertrochanteric fracture

目的探讨动力髋螺钉（DHS）和锁定钢板内固定治疗股骨转子间骨折的临床疗效。方法将50例老年股骨转子间骨折患者根据随机数字表法分为锁定钢板组（25例）和DHS组（25例）,比较两组切口长度、手术时间、术中出血量、术后引流量、住院时间、Barthel生活指数、骨折愈合时间、肢体短缩程度、疗效及术后并发症情况。结果两组患者术后均获随访,时间6～12个月。髋关节功能Harris评分：锁定钢板组优14例,良9例,可2例,差0例,优良率23/25;DHS组优9例,良13例,可2例,差1例,优良率22/25;两组比较差异无统计学意义（P〉0.05）。两组住院时间、Barthel生活指数、术后并发症情况比较差异无统计学意义（P〉0.05）。锁定钢板组患者在手术时间、切口长度、术中出血量、术后引流量、骨折愈合时间、肢体短缩程度方面与优于DHS组（P〈0.05）。结论 DHS和锁定钢板内固定治疗股骨转子间骨折均疗效显著,但锁定钢板内固定具有切口小、出血少、手术时间短等优点。

Objective To investigate the effect for treatment of femoral fractures by using the dynamic hip screw（ DHS） and locking plate internal fixation. Methods 50 cases of elderly patients with femoral fractures were divided into locking plate group（ 25 cases） and DHS group（ 25 cases） according to treatment method. It was compared between two groups that patients with incision length,operative time,intraoperative blood loss,postoperative flow,length of hospital stay and Barthel index of life,bone union time,limb shortening degree,curative effect and complications. Results Two groups of patients were followed up for 6 ～ 12 months. Harris hip joint function scores： locking plate group was 14 cases with excellent,9 good,2 fair,the excellent-good rate was 23 /25; DHS group of 9 cases were evaluated with execellent,13 good,2 fair,1 poor,and excellent-good rate was 22 /25; There was not statistical significance between the two groups（ P〉0. 05）. Two groups of patients in hospital time,Barthel index of life,the postoperative complications situation had no statistically significant difference（ P〈0. 05）. Locking plate group of patients were better than DHS group in the operation time,incision length,intraoperative blood loss,postoperative flow,bone union time,degree of limb shortening（ P〈0. 05）. Conclusions DHS and locking plate internal fixation are effective in treatment of intertrochanteric femoral fractures,but the locking plate internal fixation has the advantages of the small incision,less bleeding,shorter operation time etc.