股骨近端防旋髓内钉与动力髋螺钉治疗老年股骨粗隆间骨折临床疗效研究

Effectiveness of Proximal Femoral Antirotation Nail and Dynamic Hip Screw Replacement in Repair of Intertrochanteric Fractures in the Elderly

目的：比较股骨近端防旋髓内钉（proximal femoral nail antirotation, PFNA）与动力髋螺钉（dynamic hip screw, DHS）固定治疗老年股骨粗隆间骨折的疗效。方法2009年5月～2013年9月共收治63例老年股骨粗隆间骨折患者。随机分为PFNA内固定组（PFNA组）31例及DHS内固定组（DHS组）32例。观察比较2组患者的术中出血量、手术时间、住院时间、骨折愈合时间以及住院期间并发症和治疗优良率（Harris评分）。结果 PFNA组的手术时间、术中出血量以及治疗优良率均明显优于DHS组，且住院期间并发症也明显少于DHS组，差异有统计学意义（P＜0.05）。结论股骨近端防旋髓内钉治疗老年股骨转子间骨折效果明显优于动力髋螺钉，具有术中手术时间短、出血量少、治愈率高、并发症少等优点，并能显著改善患者的生活质量。

Objective To compare the therapeutic effect between proximal femoral nail antirotation （PFNA） and dynamic hip screw （DHS） on intertrochanteric fracture of femur.Methods A retrospective study was conducted on 63 intertrochanteric fractures （EvansⅠ~Ⅳ） of the elderly treated with DHS （31 cases） and PFNA （32 cases） in our hospital from May 2009 to September 2013. The main outcome measures included operation time, operation blood loss, hospitalization days, fracture healing time, complications and treatment excellent rate （Harris hip score）.Results All cases were followed up successfully. The operation time and blood loss in PFNA group were signifi cantly less than those in DHS group, and during the period of hospitalization, complications were signifi cantly less than DHS group （P〈0.05）.ConclusionPFNA treatment has advantages of the operation of short operation time, less bleeding, cure rate, less complications and other advantages, and can signifi cantly improve the patient＇s quality of life.