摘要
目的比较两种不同内固定方法治疗老年股骨转子间骨折的效果。方法回顾分析2007年1月—2014年12月我院手术治疗的老年股骨转子间骨折病人97例,其中采用动力髋螺钉(DHS)固定37例(DHS组),股骨近端髓内钉(PFN)固定60例(PFN组)。比较两组的手术时间、术中出血量、术后开始下床活动时间、术后髋关节功能Harris评分及治疗效果。结果 DHS组和PFN组的术中出血量分别为(400±100)、(150±50)mL,手术时间分别为(110±20)、(75±20)min,术后开始下床活动时间分别为(90±15)、(35±5)d,两组比较差异均有统计学意义(t=8.372~21.577,P〈0.01)。两组病人术后3、6、12个月时的Harris评分差异有显著性(t=5.145~10.841,P〈0.05)。随访12~24个月,DHS组、PFN组的优良率分别为70.27%、90.00%,差异有统计学意义(χ2=9.612,P〈0.05)。结论两种内固定方法均为治疗老年股骨转子间骨折的有效方法,PFN手术具有创伤小、失血量少、下床早等优点,疗效优于DHS,适用于各种类型的转子间骨折。
Objective To compare the efficacy of two kinds of internal fixation for intertrochanteric fractures in the elderly. Methods A retrospective analysis was done in 97 elderly with intertrochanteric fractures treated in our hospital during January 2007-December 2014.Of the 97 patients,37underwent dynamic hip screw(DHS),and 60 received proximal femoral nail(PFN).Operation time,blood loss at surgery,time of post-operative out-of-bed activity,post-operative Harris score of hip function and the effectiveness were compared between the two methods. Results In the DHS group and PFN group,blood loss was(400±100)mL in DPS and(150±50)mL in PFN,operation time was(110±20)min versus(75±20)min,the time of out-ofbed activity was(90±15)days versus(35±5)days.The differences in the above items between the two methods were significant(t=8.372-21.577,P〈0.01).The difference in Harris score between the two groups,after 3,6and 12 months after operation,was statistically significant(t=5.145-10.841,P〈0.05).A follow-up of 12-24 months showed the excellent rates in DHS and PFN groups were 70.27% and 90.00%,respectively(χ2=9.612,P〈0.05). Conclusion The two internal fixation methodsdynamic hip screw and proximal femoral nail-are both effective for seniors with intertrochanteric fractures,but the latter is superior to the former on the following items:minimally invasive,less blood loss,and early out-of-bed activity,which is suitable for various types of intertrochanteric fractures.
出处
《青岛大学医学院学报》
CAS
2016年第4期455-457,共3页
Acta Academiae Medicinae Qingdao Universitatis
关键词
股骨颈骨折
老年人
骨折固定术
内
治疗结果
femoral neck fractures
aged
fracture fixation
internal
treatment outcome