股骨近端防旋髓内钉和动力髋螺钉治疗老年股骨转子间骨折疗效比较

Effect comparison of the treatment of elderly femoral intertrochanteric fractures with the proximal femoral nail anti-rotation and dynamic hip screw

目的比较股骨近端防旋髓内钉（PFNA）和动力髋螺钉（DHS）治疗老年股骨转子间骨折的疗效。方法100例老年股骨转子间骨折患者按完全随机分组方法分为两组,每组50例,分别进行PFNA、DHS治疗,比较两组的手术指标和疗效。结果患者均获得随访,时间12~14个月。PFNA组手术时间、术中出血量以及术后并发症均低于DHS组,关节功能优良率高于DHS组,差异均有统计学意义（P〈0.01）。两组骨折愈合时间比较差异无统计学意义（P〉0.05）。结论 PFNA治疗老年股骨转子间骨折出血少,手术时间短,更适合治疗手术耐受性差的老年患者。

Objective To compare the treatment effects of elderly fermoral intertrochanteric fracture with the proximal femoral nail anti-rotation（ PFNA） and dynamic hip screw（ DHS）. Methods 100 cases of femoral intertrochanteric fracture patients were randomly divided into PFNA group（ n = 50） and DHS group（ n = 50）,the operation index and curative effect of two groups were compared. Results Two groups both received postoperative follow-up of 12 ~ 14 months. In PFNA and DHS group,the blood loss and the operative time were both significant difference,PFNA group was lower than DHS group. The PFNA group had a good hip Harris＇ score,was better than the DHS group in the excellent-good rate of hip joint function（ P〈0. 01）. But for the fracture healing time,there was no significant difference（ P〈0. 05）. Conclusions PFNA in the treatment of femoral intertrochanteric fracture has advantages in minimally invasion,less blood loss and is more suitable for elderly patients who can not tolerate long time operations.