防旋股骨近端髓内钉和动力髋螺钉治疗老龄股骨粗隆间骨折疗效比较

Comparison of efficacy of anti-rotation proximal femoral nail and dynamic hip screw in treatment of senile intertrochanteric fracture

目的:探讨防旋型股骨近端髓内钉(PFNA)和动力髋螺钉(DHS)在老龄股骨粗隆间骨折中的治疗效果。方法:选取收治的股骨粗隆间骨折老龄患者84例,随机分为PFNA组(n=42)和DHS组(n=42),前者行PFNA治疗,后者行DHS治疗,对比2组手术指标、术后并发症和髋关节功能恢复情况。结果:(1)PFNA组切口长度值、手术出血量值和手术时间值均显著地短于或少于DHS组(P<0.05)。(2)PFNA组并发症发生率为4.8%,显著少于DHS组的23.8%(P<0.05)。(3)PFNA组髋关节恢复优良率为92.9%,DHS组为71.4%,差异有统计学意义(P<0.05)。结论:在老龄股骨粗隆间骨折治疗上,PFNA法各项手术指标佳,术后并发症少,有利于髋关节功能恢复,是一种较理想的治疗方法。

Objective：To investigate the effect of anti-rotation proximal femoral nail （PFNA） and dynamic hip screw （DHS） in treatment of aged intertrochanteric fracture. Methods：84 cases of aged patients with intertrochanteric fracture were selected and randomly divided into a PFNA group （ n = 42 ） and a DHS group （ n = 42 ）. The former received PFNA treatment, and the latter were treated with DHS. The two groups were compared in terms of operation indexes,postoperative complications and hip function recovery. Results ： The length of incision, the amount of bleeding and operation time were significantly shorter or less in group PFNA than in group DHS（ P 〈0.05 ）. The incidence rate of complications in group PFNA was 4.8% ,which was significantly lower than that in group DHS ＇23.8% （P 〈 0.05 ）. The excellent rate of hip recovery in PFNA group was 92.9% ,which was significantly higher than that in group DHS＇71.4% （P 〈 0.05）. Conclusion：In treatment of old femoral intertrochanteric fracture, the PFNA method is a good choice for the recovery of hip joint function.