滑动加压动力髋螺钉与股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的临床对比分析

Clinical comparative analysis of sliding compression dynamic pip screw and proximal femoral anti-rotation intramedullary nail in treatment of elderly patients with femoral intertrochanteric fracture

目的探讨滑动加压动力髋螺钉和股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的疗效。方法选取本院2011年12月~2014年12月诊治的老年股骨粗隆间骨折患者110例,根据治疗方案分为两组,55例患者采用滑动加压动力髋螺钉治疗为对照组,55例患者采用股骨近端防旋髓内钉治疗为观察组。结果观察组患者手术时间（53.87±10.26）min、术中出血量（179.03±34.18）m L、术后住院时间（11.76±2.50）d均明显少于对照组（70.15±12.43）min、（276.58±24.27）m L（14.38±2.79）d,术后负重时间（26.72±4.15）d、、骨折愈合时间（7.56±1.03）周均明显早于对照组（38.91±5.69）d、（8.34±1.17）周,术后髋关节功能优良率98.18%、Harris评分（92.37±5.14）分、治疗总有效率98.18%均明显高于对照组85.45%、（81.25±3.70）分、83.64%,并发症发生率1.82%明显低于对照组12.73%,差异有统计学意义（P〈0.05）。结论滑动加压动力髋螺钉和股骨近端防旋髓内钉均是治疗老年股骨粗隆间骨折的有效方法,其中股骨近端防旋髓内钉的治疗效果更佳,具有创伤小、术后恢复快、疗效显著、并发症少等优点,值得临床推广使用。

Objective To explore curative effect of sliding compression dynamic hip screw and proximal femoral anti-rotation intramedullary nail in treatment of elderly patients with intertrochanteric fracture. Methods 110 elderly patients with intertrochanteric fracture who were admitted to our hospital from December 2011 to December 2014 were selected and they were allocated to two groups according to therapeutic schemes. 55 patients who were received sliding compression dynamic hip were selected as the control group and 55 patients who were received proximal femoral anti-rotation intramedullary nail were selected as the observation group. Results Operation time （53.87 ± 10.26） min, intraoperative bleeding volume （53.87 ±10.26）min and postoperative hospitalization time （11.76 ± 2.50）d of the observation group were all significantly less than those of the control group （70.15 ± 12.43）min, （276.58 ±24.27）mL and （14.38 ± 2.79）d. Postoperative weight-bearing time （26.72 ± 4.15）d and fracture healing time （7.56 ± 1.03）weeks of the observation group were both significantly earlier than those of the control group （38.91 ±5.69）d and （8.34 ± 1.17）weeks. Excellent rate of postoperative joint function 98.18%, Harris score （92.37 ± 5.14）points and the total effective rate 98.18% of the observation group were all significantly higher than those of the control group 85.45% , （81.25 ±3.70） points and 83.64%. Incidence rate of complication in the observation group 1.82% was significantly lower than that of the control group 12.73%（P 〈 0.05）. Conclusion Sliding compression dynamic hip screw and proximal femoral anti-rotation intramedullary nail are both effective methods in treatment of elderly patients with intertrochanteric fracture. Proximal femoral anti-rotation intramedullary nail has a better curative effect including fewer traumas, faster postoperative recovery, significant curative effect, fewer complications and so on. It is worthy of clinical application.