3种内固定手术治疗老年股骨粗隆间骨折的临床对照分析

Comparative analysis of three types of internal fixation for intertrochanteric fractures in elder patients

目的分析3种内固定手术治疗老年股骨粗隆间骨折患者的手术相关指标。方法选择93例老年股骨粗隆间骨折患者,按照治疗方式不同分为PFNA组、DHS组和LISS组,每组各31例,对比3组的手术相关指标。结果 PFNA组的手术时间短于DHS组、长于LISS组,术中出血量少于DHS组、多于LISS组,切口大小、术后引流量和卧床时间均优于LISS组和DHS组,组间差异均有统计学意义(均P<0.05)。结论首选股骨近端防旋髓内钉内固定术治疗老年股骨粗隆间骨折患者,如果患者存在合并股骨近端外侧壁骨折或梨状窝骨折可以选择倒置股骨远端微创内固定系统治疗。

Objective To analyze the related surgical indicators of three types of internal fixation surgery for intertrochanteric fractures in elder patients. Methods 93 elder patients of femoral intertrochanteric fractures were selected and divided into PFNA group, DHS group and LISS group according to different treatment methods, with 31 cases in each group, and the operation-related indicators of the three groups were compared. Results In PFNA group, the operation time was shorter than DHS group and longer than LISS group, intraoperative blood loss was less than DHS group and more than LISS group, wound size, postoperative drainage and bed rest time were better than LISS and DHS group. All of differences between groups were statistically significant(both P<0.05). Conclusion Proximal femoral anti-rotational intramedullary nailing is preferred for intertrochanteric fractures in elder patients. If the patients with proximal femoral lateral wall fracture or a piriform fossa fracture, an inverted minimally invasive internal fixation system in the distal femur can be selected.