DHS、PFN与FHR治疗股骨粗隆间骨折的临床对比

Comparison of DHS, PFN and FHR in the treatment of femoral intertrochanteric fractures

目的分析动力髓螺钉(DHS)、股骨近端髓内钉(PFN)与人工股骨头置换术(FHR)治疗股骨粗隆间骨折的临床效果。方法以回顾性分析方法选取我院2010—2014年收治的405例股骨粗隆骨折患者,其中有125例患者以DHS手术方式治疗,设为DHS组;有75例患者以PFN方式治疗,设为PFN组;有205例患者的手术方式为FHR,设为FHR组,对比三组患者的手术治疗结果。结果 FHR组的术中出血量、手术时间均低于其他两组,差异有统计学意义(P<0.05);术后,FHR组Harri评分优于DHS组和PFN组(P<0.05);术后回访6~24个月,三组患者的髋关节功能均恢复良好,可在无外力帮助情况下进行负重行走。结论 FHR手术方式治疗不稳定性股骨粗隆间骨折,手术时间短、术后出血少、患者术后的恢复快,治疗效果好。

ObJective To compare the clinical effects of dynamic screw （DHS）, proximal femoral nail （PFN） and artificial femoral head replacement （FHR） in the treatment of femoral intertroehanteric fractures. Methods From 2010 to 2014, 405 cases of patients with femoral intertroehanteric fractures in our hospital were retrospectively analyzed. One hundred and twenty-five patients were treated with DHS surgery, served as the DHS group; 75 patients were treated with PFN, served as the PFN group; 205 cases of surgical patients with FHR, served as the FHR group. The surgical treatment results of the three groups were compared. Results The intraoperative blood loss and operation time of the FHR group were lower than those of the other two groups, the differences were statistically significant （P〈0.05）. The Harri score of the FHR group was better than that of DHS group and PFN group （P〈0.05）; after 6-24 months of operation, hip function of the three groups were restored well, patients could carry weight-bearing walking without the help of external forces. Conclusion FHR is a safe and effective treatment for unstable femoral intertrochanterie fractures, with short operation time and less postoperative bleeding.