PFNA与DHS内固定治疗老年股骨粗隆间骨折的对比研究

Comparative study on PFNA and DHS internal fixation in treatment of intertrochanteric fractures of femur in aged patients

目的比较股骨近端防旋髓内钉和动力髋螺钉内固定治疗老年股骨粗隆间骨折的临床疗效。方法回顾性分析2013年7月～2016年7月广东省肇庆市高要区人民医院收治的80例老年股骨粗隆间骨折患者的临床资料,根据治疗方式的不同分为两组,其中PFNA内固定42例、DHS内固定38例,比较两组患者手术时间、切口长度、术中出血量、骨折愈合时间、髋关节功能恢复情况及并发症发生情况。结果 PFNA组手术时间、切口长度、术中出血量较DHS组小,骨折愈合时间较DHS组快,两组比较差异有统计学意义(P <0.05)。PFNA组患者术后髋关节功能恢复优良率为85.7%,较DHS组的60.5%高(χ2=5.130,P=0.023)。术后并发症4.8%较DHS组少。结论 PFNA内固定治疗老年股骨粗隆间骨折方法创伤更小、术后恢复更快、并发症较少的优点,临床疗效好,值得推广。

Objective To compare the clinical effects of proximal femoral nailing anti-rotation(PFNA)and dynamic hip screw(DHS)internal fixation in treatment of intertrochanteric fractures of femur in aged patients.Methods Clinical data of 80 aged patients with intertrochanteric fractures of femur who were admitted and treated in Gaoyao District People's Hospital of Zhaoqing in Guangdong province from July 2013 to July 2016 were retrospectively analyzed.According to the different treatment methods,they were divided into the PFNA internal fixationgroup with 42 cases and the DHS internal fixation group with 38 cases.Operation time,incision length,intraoperative blood loss,fracture healing time,hip joint function recovery and occurrence of complications of patients in two groups were compared.Results Operation time,incision length and intraoperative blood loss in the PFNA group were smaller than those in DHS group and fracture healing time was shorter than the DHS group.The difference between two groups was statistically significant(P<0.05).The excellent and good rate of postoperative hip joint function recovery in PFNA group was 85.7%,higher than that in the DHS group 60.5%(χ2=5.130,P=0.023).The occurrence rate of postoperative complications in PFNA group was 4.8%.Conclusion Compared with DHS group,PFNA has the advantages of less trauma,faster postoperative recovery and fewer complications.It has a good clinical effect,which is worthy of promotion.