防旋型股骨髓内钉与鹅头钉钢板治疗股骨粗隆间骨折的对比研究

Comparative Study of Proximal Femoral Nail Anti-rotation and Dynamic Hip Screw for Treatment of Femoral Intertrochanteric Fracture

目的:对比研究防旋型股骨髓内钉(PFNA)与鹅头钉钢板(DHS)治疗股骨粗隆间骨折的效果。方法:选择2014年3月-2016年3月本院收治的60例股骨粗隆间骨折患者作为研究对象,根据随机数字表法将其分成PFNA组和DHS组,各30例。PFNA组应用防旋型股骨髓内钉治疗,DHS组应用鹅头钉钢板治疗。随访12个月,比较两组治疗效果。结果:PFNA组的手术时间、术中出血量、负重时间、骨折愈合时间均优于DHS组,差异均有统计学意义(P<0.05);随访1个月,PFNA组的Harris评分明显优于DHS组,差异有统计学意义(P<0.05);随访3、6、12个月,两组同一时段组间的Harris评分比较,差异均无统计学意义(P>0.05)。结论:PFNA治疗方式可以缩短手术时间,减少术中出血量,缩短负重时间和骨折愈合时间,而且PFNA短期治疗效果明显优于DHS,可见PFNA治疗股骨粗隆间骨折疗效更为理想,值得推广应用。

Objective：To compare proximal femoral nai lanti-rotation（PFNA） and dynamic hip screw（DHS） in the treatment of femoral intertrochanteric fracture.Method：A total of 60 patients with femoral intertrochanteric fracture treated in our hospital from March 2014 to March 2016 were selected as the research objects and were divided into PFNA group and DHS group according to random number table method,30 cases in each group.PFNA group was treated with proximal femoral nail anti-rotation,and DHS group was treated with dynamic hip screw.The patients were followed up for 12 months,and the therapeutic effects of the two groups were compared.Result：The operation time,intraoperative bleeding volume,weight-bearing time and fracture healing time of PFNA group were better than those of DHS group,the differences were statistically significant（P〈0.05）.After 1 month of follow-up,the Harris score of the PFNA group was significantly better than that of the DHS group,the difference was statistically significant（P〈0.05）.At 3 months,6 months,12 months of follow-up,there were no significant differences in Harris scores between of two groups at the same period（P〉0.05）.Conclusion：PFNA treatment can shorten operation time,reduce intraoperative blood loss,weight-bearing time and fracture healing time,and PFNA short-term treatment effect is obviously better than DHS,so,PFNA is more ideal for treating femoral intertrochanteric fractures,and it is worthy of promotion and application.