不同手术方式在股骨转子间骨折患者中的应用效果对比

Application Effect of Different Operation Modes for Femoral Intertrochanteric Fractures

目的研究采用第四代股骨髓内钉Inter TAN、股骨近端防旋髓内钉PFNA和髋动力螺钉DHS治疗股骨转子间骨折的临床效果。方法选取2011年5月至2014年11月间在我院进行治疗的股骨转子间骨折患者180例,按照随机数字表法分为DHS组60例、Inter TAN组60例和PFNA组60例。收集三组患者术中出血量、手术耗时、术后住院时间、术后负重时间和骨折愈合时间,以及三组患者Sanders髋关节创伤后评分等数据,并进行统计学分析。结果手术时间、术后住院时间、术后负重时间、骨折愈合时间、术后并发症DHS组高于PFNA组和Inter TAN组,数据比较差异明显,具有统计学意义(P<0.05)。术中出血量DHS组高于PFNA组和Inter TAN组,PFNA组高于Inter TAN组,具有统计学意义(P<0.05)。优良率三组间两两比较,数据差异不明显,不具有统计学意义(P>0.05)。结论 Inter TAN和PFNA治疗股骨转子间骨折与传统的DHS方式相比更符合微创手术的要求,治疗优势明显,而两种方式间术后恢复和并发症发生率等差异不明显。

Objective To study the clinical effects of the fourth generation of femoral intramedullary nail（ Inter TAN）,proximal femoral nail anti-rotation（ PFNA） and dynamic hip screw（ DHS） in the treatment of intertrochanteric femoral fractures. Methods 180 cases with femoral intertrochanteric fractures were selected from May 2011 to November 2014,and were randomly divided into DHS group of 60 cases,Inter TAN group of60 cases and PFNA group of 60 cases. It was collected of the bleeding volume,operation time,postoperative hospital stay,postoperative weight-bearing time,fracture healing time,and Sanders hip function score of the three groups. Results The operative time,postoperative hospital stay,postoperative weight-bearing time,fracture healing time,postoperative complications of DHS group was higher than that in PFNA group and InterTAN group,and the difference was statistically significant（ P 〈0. 05）. The amount of intraoperative bleeding in Inter TAN group was higher than the DHS group and the PFNA group,and the PFNA group was higher than that of the Inter TAN group,the difference was statistically significant（ P 〈0. 05）. There was no statistical significance among the three groups comparing of the Sanders hip function scores after operation（ P 〉0. 05）.Conclusion Comparing with the traditional DHS,it shows less invasion and more superiorities of the Inter TAN and PFNA in the treatment of femoral intertrochanteric fracture with quick postoperative recovery and few complication rate.