动力髋螺钉与股骨近端防旋型髓内钉治疗股骨粗隆间骨折效果对比

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

目的对比观察动力髋螺钉(dynamic hip screw,DHS)与股骨近端防旋型髓内钉(proximal femoral nail antirotation,PFNA)治疗股骨粗隆间骨折的效果。方法选择2014年5月—2016年5月收治的股骨粗隆间骨折患者94例,随机分为对照组、观察组各47例。对照组行DHS治疗,观察组行PFNA治疗。对比两组切口长度、术中出血量、术后引流量、手术时间、骨折愈合时间、住院时间、部分负重时间;比较两组髋关节功能、并发症。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果对照组切口长度、术中出血量、术后引流量、手术时间、骨折愈合时间、住院时间、部分负重时间[(10.67±1.85)cm、(305.84±56.76)、(204.78±34.62)ml、(93.52±16.83)min、(15.05±1.90)、(15.23±3.45)、(42.68±5.07)d]与观察组[(5.43±1.24)cm、(200.16±42.35)、(150.39±25.17)ml、(69.48±12.41)min、(12.48±1.40)、(11.37±2.19)、(38.32±4.95)d]比较差异有统计学意义(均P<0.05)。对照组优良率76.59%,观察组91.49%,两组比较差异有统计学意义(P<0.05)。对照组并发症发生率17.02%,观察组4.26%,两组比较差异有统计学意义(P<0.05)。结论在股骨粗隆间骨折治疗中,PFNA更具有优势,骨折愈合良好,髋关节功能恢复优良率高、并发症少。

Objective To investigate the application effects of dynamic hip screw （DHS） and proximal femoral nail anti-rotation （PFNA） in treatment of femoral intertrochanteric fracture. Methods 94 patients with femoral intertrochanteric fracture admitted into our hospital from May 2014 to May 2016 were randomly divided into two groups, 47 cases in each. Control group was treated with DHS, observation group was treated with PFNA. The incision length, intraoperative bleeding volume, postoperative drainage volume, excellent rate of hip joint function and incidence of complications of two groups were compared. Measurement data uses t test,and count data uses x^2 test, P〈0.05 is considered statistically significant.Results The incision length, intraoperative bleeding volume, postoperative drainage volume of observation group[ （ 10.67 ± 1.85） cm, （305.84 ± 56.76 ） , （ 204.78 ：t： 34.62） ml, （93.52± 16.83）rain, （15.05± 1.90） , （15.23±3.45） , （42.68±5.07）d] were significantly better than control group[（ 5.43 ± 1.24）cm ,（ 200.16 ± 42.35 ） ,（ 150.39 ± 25.17 ）ml ,（ 69.48 ± 12.41 ）rain ,（ 12.48 ± 1.40 ） ,（ 11.37 ± 2.19） ,（ 38.32 ± 4.95 ） d]（all P〈0.05）.The excellent rate of hip joint function of observation group （91.49%） was significantly higher than control group （76.59%） （P〈0.05）.The incidence of complications of observation group （4.26%） significantly decreased compared with control group （17.02%） （P〈0.05）. Conclusion PNFA has more significant advantages in the treatment of femoral intertrochanteric fracture, it has relatively ideal surgical indexes, good fracture healing, high good rate of hip joint function and less complications, which has higher application value compared with DHS.