DHS与PFNA固定治疗老年股骨粗隆间骨折的临床效果比较

Comparison of Clinical Effects of Fixed DHS and PFNA in the Treatment of Senile Intertrochanteric Femoral Fractures

目的对比分析DHS(动力髋螺钉)与PFNA(股骨近端防旋髓内钉)固定治疗老年股骨粗隆间骨折的临床疗效。方法方便选取2015年8月—2017年8月该院骨科接诊的78例老年股骨粗隆间骨折患者作为观察对象,根据随机对照试验方法将入选患者分为两组,每组39例。一组患者采用DHS治疗,即对照组,另一组患者采用PFNA治疗,即治疗组。通过观察两组患者的手术相关指标、骨折恢复优良率、并发症情况,对比DHS与PFNA固定治疗老年股骨粗隆间骨折的临床疗效。结果治疗组患者功能恢复优良率94.87%明显高于对照组化患者功能优良率79.49%(χ~2=10.582 2,P=0.001 1);与对照组比较,治疗组手术时间更短、出血量更少、负重时间及骨折愈合时间更短(P<0.05);治疗组并发症发生率5.13%%明显少于对照组并发症发生率30.77%(χ~2=22.318 4,P=0.000 0)。结论 DHS与PFNA固定均是治疗老年股骨粗隆间骨折的理想术式,但与DHS比较,PFNA固定治疗更利于骨折愈合,且术后并发症少,手术时间短,出血少,较DHS固定治疗更有优势,更具有临床推广价值。

Objective This paper tries to compare and analyze the clinical efficacy of DHS（dynamic hip screw） and PFNA（proximal femoral nail） in the treatment of intertrochanteric fractures in the elderly. Methods 78 elderly patients with intertrochanteric fractures admitted from August 2015 to August 2017 in this hospital were convenient selected as observation objects. According to randomized controlled trials, the selected patients were divided into two groups, with 39 in each group.One group of patients was treated with DHS, as the control group, and the other group was treated with PFNA, as the treatment group. By observing the relevant indicators of surgery, fracture recovery, excellent rate, and complications of the two groups of patients, compared the clinical efficacy of DHS and PFNA in the treatment of intertrochanteric fractures in the elderly. Results The excellent and good rate of functional recovery in the treatment group was 94.87%, which was significantly higher than that in the control group 79.49%（χ2=10.582 2, P=0.001 1）. Compared with the control group, the treatment group had shorter operation time, less bleeding, and weight-bearing time. The fracture healing time was shorter（P〈0.05）. The incidence of complications in the treatment group was 5.13% was significantly lower than that in the control group（30.77%）（χ2=22.318 4, P =0.000 0）. Conclusion Both DHS and PFNA fixation are ideal for the treatment of intertrochanteric fractures in the elderly. However, compared with DHS, PFNA fixation is more conducive to fracture healing,and has fewer postoperative complications, shorter operative time, less bleeding, and is more stable than DHS. There are advantages and more clinical promotion value.