3种不同方式内固定治疗老年稳定型股骨粗隆间骨折的临床疗效观察

The clinical observation of three different internal fixations in treating elderly stable femoral intertrochanteric fracture

目的探讨锁定钢板(LCP)固定、动力髋螺钉(DHS)内固定和股骨近端髓内钉(PFNA)内固定治疗老年股骨粗隆间骨折的疗效。方法选择老年稳定型股骨粗隆间骨折患者60例,随机分至股骨近端LCP固定组(A组)、DHS内固定组(B组)和PFNA固定组(C组),对3组患者手术时间、出血量、术后负重时间及并发症发生情况进行分析和比较。结果 A组、B组、C组与在术中出血量、术后负重时间及手术时间的比较具有统计学意义(P<0.05)。C组优良率显著优于A组(P<0.05)。A组出现2例髋内翻,1例断钉、退钉,1例浅表感染;B组出现1例髋内翻;C组出现1例股骨转子间再骨折。结论 LCP固定、DHS内固定和PFNA均为老年稳定型股骨粗隆间骨折的有效治疗方式。

Objective To compare the clinical efficacy of locking plate（LCP）,dynamic hip screw（DHS）and proximal femoral nail（PFNA）internal fixation in the treatment of elderly stable femoral intertrochanteric fracture.Methods A total of 60 patients with stable stable intertrochanteric fractures in elderly patients were randomly divided randomly into proximal femoral LCP fixation group（group A）,the DHS fixation group（group B）and PFNA fixation group（group C）.The operative time,blood loss,postoperative complications and postoperative weight-bearing time were analyzed among three different groups.Results There were significant difference in blood loss,postoperative weight-bearing time,operative time among three different groups（P〈0.05）.Group C was significantly better than the group A（P〈0.05）.Two cases of hip varus deformity,one case of crew loosening and superficial infection were appeared among group A.One case of hip varus deformity occurred in group B.One case of suffered refracture occurred in group C.Conclusion LCD fixation,fixation with DHS and PFNA fixation are effective treatment for stable femoral intertrochanteric fracture in the elderly patients.