不同内固定方法治疗老年股骨粗隆间骨折的疗效比较

Comparison of intertrochanteric fractures in the elderly in treatment of different internal fixation methods

目的 比较不同内固定方法在老年股骨粗隆间骨折治疗中的临床效果。方法 回顾性分析2014年1月~2015年10月我院治疗的70例老年股骨粗隆间骨折患者的临床资料,按照治疗方法分为观察组和对照组,每组35例,观察组采用股骨近端防旋髓内钉（PFNA）,对照组采用动力髋加压螺钉（DHS）,比较两组的手术时间、住院时间、骨折愈合时间,术中出血量及优良率。结果 观察组的手术时间、住院时间、骨折愈合时间短于对照组,术中出血量少于对照组,差异有统计学意义（P〈0.05）。观察组术后髋关节Harris评分、优良率与对照组比较,差异无统计学意义（P〉0.05）。结论 老年股骨粗隆间骨折患者无论采用DHS还是PFNA治疗,术后患者髋关节功能恢复情况较好,但与DHS比较,PFNA能减少术中出血量,缩短住院时间及骨折愈合时间,优势更明显。

Objective To compare the clinical effects of different internal fixation methods in the treatment of intertrochanteric fractures of the elderly. Methods The clinical data of 70 elderly femur intertrochanteric fractures were analyzed retrospectively, all the patients were selected from January 2014 to October 2015 in our hospital. The patients were divided into two groups according to the treatment methods, the observation group and the control group,there were35 cases in each group. The observation group was treated with PFNA, the control group was treated with DHS, the time of operation, hospital stays, fracture healing time, intraoperative blood loss and excellent rate of two groups were compared. Results The operative time, hospital stays and fracture healing time of the observation group were shorter than those of the control group, the amount of blood loss in the observation group was less than that in the control group,there was significant difference（P〈0.05）. There were no significant differences in the Harris score of the hip joint, excellent rate between the observation group and the control group（P〉0.05）. Conclusion The functional recovery of hip joint is better in patients with intertrochanteric fracture of femur treated with DHS or PFNA. Compared with DHS, PFNA can reduce the amount of blood loss, shorten hospital stays and fracture healing time. The advantage is more obvious.