PFNA与DHS内固定治疗小儿麻痹症患者股骨粗隆间骨折

PFNA and DHS internal fixation in the treatment of femoral intertrochanteric fracture in patients with poliomyelitis

目的通过应用PFNA和DHS内固定治疗小儿麻痹症患者股骨粗隆间骨折的比较,探讨1种治疗该骨折较为可靠的内固定方法。方法选取2008年3月~2015年11月我院采用PFNA或DHS内固定治疗的小儿麻痹症股骨粗隆间骨折患者19例作为研究对象,分析其临床资料。按照固定方式的不同,将其分为两组,PFNA组8例和DHS组11例。随访9~18个月,对两组患者的手术情况、住院情况、术后疗效进行比较,并进行统计学分析。结果PFNA组手术时间、透视次数较DHS组更长更多,住院费用及术后康复费用更多,差异有统计学意义(P<0.05);两组术中出血量、骨折愈合时间、愈合率及术后并发症发生率比较,差异无统计学意义(P>0.05)。DHS固定骨折术后,髋关节优良率为90.9%(10/11),明显高于PFNA固定的62.5%(5/8),差异有统计学意义(P<0.05)。结论较PFNA内固定,DHS能有效固定治疗小儿麻痹患者股骨粗隆间骨折,具有操作简单、疗效好、医疗费用低、并发症少等优势,值得临床推广应用。

Objective To compare the use of PFNA and DHS internal fixation to treat femoral intertrochanteric fractures of patients with poliomyelitis,and to explore a more reliable internal fixation method for the treatment of this fracture.Methods Nineteen patients with femoral intertrochanteric fracture in patients with poliomyelitis who were treated with PFNA or DHS internal fixation from March 2008 to November 2015 in our hospital were selected as the research subjects,and their clinical data were analyzed.According to the different fixing methods,they were divided into 2 groups,8 cases in PFNA group and 11 cases in DHS group.They were followed up for 9-18 months.The surgical conditions,hospitalization,and postoperative efficacy of the two groups were compared and statistically analyzed.Results Operation time and fluoroscopy times in PFNA group were longer than DHS group,hospitalization cost and postoperative rehabilitation cost were more,and the differences were statistically significant(P<0.05).There were no statistically significant differences in intraoperative blood loss,fracture healing time,healing rate and incidence of postoperative complications between the two groups(P>0.05).After DHS fixation fracture,the excellent rate of hip joint accounted for 90.9%(10/11),which was significantly higher than 62.5%(5/8)of PFNA fixation,and the difference was statistically significant(P<0.05).Conclusion Compared with PFNA internal fixation,DHS can effectively fix femoral intertrochanteric fractures in patients with poliomyelitis.It has the advantages of simple operation,good efficacy,low medical cost,and few complications.It is worthy of clinical application.