DHS、PFNA与锁定加压钢板治疗稳定型股骨转子间骨折

The application effect of DHS,PFNA and locking compression plate in patients with stable intertrochanteric fractures

目的探究采用动力髋螺钉(DHS)、股骨近端防旋髓内钉(PFNA)、锁定加压钢板(LCP)在稳定型股骨转子间骨折患者中的应用效果。方法研究对象选择我院2013年5月至2016年5月收治的90例股骨转子间骨折患者,按固定方法不同分为DHS组、PFNA组、LCP组,每组各30例。对比3组手术情况、骨折愈合时间、并发症发生率,同时对比两组随访后的Harris评分。结果 PFNA组的手术时间、切口长度、周围骨折、出血量、住院时间、骨折愈合时间及并发症发生率均明显优于DHS组及LCP组,组间差异显著(P<0.05);3组患者输血量比较均无显著差异(P>0.05);随访显示,3组Harris评分无显著性差异(P>0.05)。结论 DHS、PFNA、LCP均有各自的适应证及特点,但相比于其他2种方法,PFNA治疗稳定型股骨转子间骨折患者的临床疗效显著,明显缩短手术时间及患者痊愈时间,且治疗安全性较高,值得临床推广。

Objective To investigate the effect of dynamic hip screw（ DHS）,proximal femoral intramedullary nail（ PFNA）and locking compression plate（ LCP） on stable femoral intertrochanteric fractures. Methods 90 patients with intertrochanteric fractures were selected and divided into DHS group,PFNA group and LCP group according to different methods,30 cases in each group.The incidence of complications,the fracture healing time and the Harris score were compared in each group. Results The operation time,incision length,surrounding fracture,bleeding volume,hospitalization time,fracture healing time and complication rate of PFNA group were significantly better than those in DHS group and LCP group,the difference was significant（ P 〈 0. 05）; There was no significant difference in blood transfusion among the three groups（ P 〉 0. 05）. There was no significant difference in Harris score among the three groups（ P 〈 0. 05）. Conclusion DHS,PFNA and LCP have their own indications and characteristics,but compared with the other two methods,PFNA treatment of stable intertrochanteric fractures in patients with clinical efficacy significantly significantly shorten the operation time and recovery time of patients,and treatment High safety,worthy of clinical promotion.