外侧壁危险型股骨粗隆间骨折行不同术式治疗的疗效比较

Comparison of therapeutic effects of different surgical methods for lateral wall dangerous intertrochanteric fracture of femur

目的探究不同术式治疗外侧壁危险型股骨粗隆间骨折的临床疗效。方法100例外侧壁危险型股骨粗隆间骨折患者,依据手术方式不同分为实验组与对照组,每组50例。对照组采用动力髋螺钉(DHS)内固定术治疗,实验组采用股骨近端防旋髓内钉(PFNA)内固定术治疗。比较两组患者手术指标及Harris髋关节功能评分、并发症发生情况。结果实验组患者手术时间、骨折愈合时间、住院时间短于对照组,术中出血量少于对照组,差异具有统计学意义(P<0.05);实验组患者Harris髋关节功能评分为(90.24±6.25)分,高于对照组的(71.35±4.36)分,差异具有统计学意义(P<0.05)。实验组患者术后并发症发生率为4.0%,明显低于对照组的16.0%,差异具有统计学意义(P<0.05)。结论采用PFNA内固定术治疗外侧壁危险型股骨粗隆间骨折,手术时间短、术中出血量少、髋关节功能得到有效改善,且术后并发症少,值得临床应用。

Objective To investigate the clinical efficacy of different surgical methods for lateral wall dangerous intertrochanteric fracture of femur. Methods A total of 100 patients with lateral wall dangerous intertrochanteric fracture of femur were divided by different surgical methods into experimental group and control group, with 50 cases in each group. The control group was treated with dynamic hip Screw(DHS) for internal fixation, and the experimental group was treated with proximalfemoral nail anti-rotation(PFNA) for internal fixation. Comparison were made on surgical indicators, Harris hip function score and complications between the two groups. Results The experimental group had shorter operation time, fracture healing time and hospitalization time than the control group, and less amount of intraoperative hemorrhage than the control group. Their difference was statistically significant(P<0.05). The experimental group had higher Harris hip function score as(90.24±6.25) points than(71.35±4.36) points in the control group, and the difference was statistically significant(P<0.05).The experimental group had obviously lower incidence of postoperative complications as 4.0% than 16.0% in the control group, and the difference was statistically significant(P<0.05). Conclusion PFNA internal fixation for the treatment of lateral wall dangerous intertrochanteric fracture of femur shows the advantages of short operation time,less amount of intraoperative hemorrhage, effective improvement of hip joint function, and fewer complications after operation. It is worthy of clinical application.