股骨近端锁定钢板与动力髋钉固定治疗老年人骨质疏松性稳定型股骨粗隆间骨折的疗效比较

Clinical comparison of LPFP and DHS surgeries for osteoporotic stable intertrochanteric fracture

目的：比较股骨近端锁定钢板（PFLP）与动力髋钉（DHS）固定治疗老年人骨质疏松性稳定型股骨粗隆间骨折的临床疗效。方法对骨质疏松性稳定型股骨粗隆间骨折的老年患者90例临床资料进行回顾性分析，根据治疗方式分为研究组与对照组，研究组41例使用 LPFP 固定治疗，对照组49例使用 DHS 固定治疗。对比两组患者手术时间、骨折愈合时间、Harris 髋关节评级、骨密度及并发症等临床指标。结果研究组与对照组住院时间[（22．56±4．76）d 比（24．65±5．13）d，t ＝2．002]、完全负重时间[（4．04±1．05）个月比（3．95±0．85）个月，t ＝0．441]、骨折愈合时间[（4．35±0．94）个月比（4．14±0．97）个月，t ＝1．040]相近，两组差异均无统计学意义（P 〉0．05），研究组术中出血量为（177．54±15．45）mL，少于对照组，差异有统计学意义（t ＝30．331，P 〈0．01）；研究组髋关节功能优良率为87．80％，高于对照组的75．51％，差异有统计学意义（χ^2＝4．014，P 〈0．05）；研究组并发症发生率为1．73％，明显低于对照组的12．24％，差异有统计学意义（χ^2＝4．558，P 〈0．05）。结论PFLP 固定与 DHS 固定治疗老年骨质疏松性稳定型股骨粗隆间骨折均有较好临床效果，但 PFLP 固定利于术后髋关节功能恢复，安全性高，值得临床推广应用。

Objective To investigate differences of clinical outcomes between PFLP and DHS in the treatment of osteoporotic stable intertrochanteric fracture patients.Methods 90 elderly patients with osteoporotic stable intertrochanteric fracture were selected retrospectively,and they were divided into study group and control group based on surgeries types.The study group was treated with LPFP,and the control group was treated with DHS.Operation time,fracture healing time,clinical indicators Harris hip rating,bone density and complications were compared. Results When compared in hospitalization time[（22.56 ±4.76）d vs.（24.65 ±5.13）d,t =2.002],full weight -bearing time[（4.04 ±1.05）months vs.（3.95 ±0.85）months,t =0.441],healing time[（4.35 ±0.94）months vs. （4.14 ±0.97）months,t =1.040],there were no statistically significant differences between the two groups（all P 〉0.05）.However,the blood loss in the study group was （177.54 ±15.45）mL,which was significantly less than that in the control group（t =30.331,P 〈0.01）.The good hip function rate in the study group was 87.80%,which was significantly higher than 75.51% in the control group （χ^2 =4.014,P 〈0.05）.Also,the incidence rate of complication in the study group was significantly lower than the control group （1.73% vs.12.24%,χ^2 =4.55,P 〈0.05 ）. Conclusion Both DHS and PFLP surgical treatment can get good clinical effect for osteoporotic stable intertrochan-teric fracture patients,but PFLP can help the hip function recovery,which is worthy of clinical application.