PFNA与DHS及股骨近端锁定接骨板在治疗老年股骨粗隆间骨折中的优势

The Advantages of PFNA and DHS and Proximal Femoral Locking Plate in the Treatment of Intertrochanteric Fractures of the Elderly

目的：探讨股骨近端防旋髓内钉、动力髋螺钉以及股骨近端锁定接骨板在老年股骨粗隆间骨折治疗中的临床效果.方法：选取我院2012年1月～2017年2月所收治的97例老年股骨粗隆间骨折患者作为此次研究对象,对患者进行随机分组治疗,PFNA组（n=33）、DHS组（n=32）、股骨近端锁定接骨板（PFLP）组（n=32）,每组进行针对性治疗,对比分析3组患者手术时间、切口长度、手术中出血量、手术后的引流量、下地时间以及骨折愈合时间,并观察3组的髋关节功能评分（Harris评分）.结果：PFNA组与其他2组相比,具有手术时间短、出血量少、下床活动时间早的优势,3组比较,存在明显的统计学意义（p〈0.05）;3组在骨折愈合无统计学意义（p〉0.05）;DHS组优良率为75.00％,PFLP组优良率为78.12％,PFNA组优良率为90.91％,PFNA组与DHS组、PFLP组相比,具有统计学意义（p〈0.05）.结论：股骨近端防旋髓内钉（PFNA）应用在老年股骨粗隆间骨折治疗中的效果明显,具有手术时间短、创伤小,手术后患者下床活动时间早的优势,值得临床推广应用.

Objectiv： To investigate the clinical effect of proximal femoral intramedullary nail, dynamic hip screw and proximal femoral locking plate in the treatment of intertrochanteric fractures of the elderly. Methods： A total of 97 elderly patients with intertrochanteric fractures were selected from January 2012 to February 2017. The patients were randomly divided into PFNA group （ n = 33 ） and DHS group （n = （N = 32）. The patients were treated with three groups of patients. The operation time, incision length, bleeding volume during operation, postoperative drainage, lower time and fracture healing were analyzed. Time, and observe the three groups of hip func- tion score （Harris score）. Results： PFNA group compared with the other two groups, with shorter operation time, less blood loss, the ad- vantage of early ambulation, the comparison group, there is an obvious statistical significance （ p 〈 O. 05 ） ; The three groups had no sta- tistical significance in fracture healing （ p 〉 O. 05 ） ; The optimum ratio of the DHS group was 75.00%, the PFLP was 78.12%, the PF- NA group was 90.91%, and the PFNA group was statistically significant （p 〈 O. 05 ） compared to the DHS and PFLP groups. Conclu- sion： The effect of proximal femoral intramedullary nail （PFNA） on the treatment of intertroehanteric fractures in the elderly was obvious, and the advantages of the operation time, the trauma and the time of getting out of bed were early. Promote the application.