PFNA内固定术与DHS应用于高龄股骨粗隆间骨折治疗中疗效对比

Comparison of PFNA Internal Fixation and DHS in the Treatment of Elderly Patients with Intertrochanteric Fractures

目的探讨股骨近端抗旋髓内钉(PFNA)与动力髋螺钉(DHS)治疗高龄股骨粗隆间骨折的临床效果差异,为临床应用提供参考依据。方法方便选取该院2010年1月—2017年8月所收治老年患者120例,随机分为研究组和对照组。研究组60例,予以PFNA内固定术;对照组60例,予以DHS内固定术。比较两组临床表现、并发症发生情况差异,并随访12个月,记录两组髋关节功能恢复情况。结果两组患者术后住院时间差异无统计学意义(P>0.05);研究组手术时间为(80.23±9.15)min、术中出血量为(180.12±47.37)mL、骨折愈合时间为(96.23±10.46)d,均明显低于对照组,差异有统计学意义(P<0.05)。研究组患者中,仅出现1例不愈合、1例螺钉松动,并发症发生率为3.33%,明显低于对照组的16.67%,差异有统计学意义(χ~2=4.537,P<0.05)。研究组患者术后6、12个月髋关节功能评分分别为(71.16±5.12)分、(90.22±4.15)分,均明显高于对照组,差异有统计学意义(P<0.01)。结论 PFNA内固定术临床表现更好,并发症更少,且更有利于患者髋关节功能恢复,尤其适用于高龄骨折患者,值得临床推广应用。

Objective To investigate the clinical effect of proximal femoral anti-rotating intramedullary nail (PFNA) and dynamic hip screw (DHS) in the treatment of intertrochanteric fractures in elderly patients,and provide reference for clinical application.Methods 120 elderly patients admitted to the hospital from January 2010 to August 2017 were conveniently selected and randomly divided into study group and control group.Sixty patients in the study group underwent PFNA internal fixation and 60 patients in the control group underwent DHS internal fixation.The clinical manifestations and complications of the two groups were compared and followed up for 12 months.The hip joint function recovery was recorded.Results There was no significant difference in postoperative hospital stay between the two groups (P>0.05).The operation time of the study group was (80.23±9.15) min,the intraoperative blood loss was (180.12±47.37)mL,and the fracture healing time was (96.23±10.46)d,were significantly lower than the control group,the difference was statistically significant (P<0.05).Among the patients in the study group,only 1 case did not heal and 1 case of screw loosening.The complication rate was 3.33%,which was significantly lower than 16.67% in the control group.The difference was statistically significant (χ^2=4.537,P<0.05).The hip joint function scores of the study group were (71.16±5.12)points and (90.22±4.15)points,respectively,which were significantly higher than the control group.The difference was statistically significant (P<0.01).Conclusion PFNA internal fixation has better clinical performance,less complications,and is more conducive to the recovery of hip function.It is especially suitable for patients with advanced fractures,which is worthy of clinical application.