两种内固定治疗股骨转子间骨折的疗效比较

Comparison effect of two internal fixations in the treatment of femoral intertrochanteric fracture

目的比较股骨近端防旋髓内钉(PFNA)和动力髋螺钉(DHS)治疗股骨转子间骨折的疗效。方法将60例股骨转子间骨折患者根据内固定方式不同分为观察组(采用PFNA治疗)和对照组(采用DHS治疗),每组30例。记录两组手术时间、术中出血量、切口长度、住院时间、术后并发症情况、骨折愈合时间及手术前后髋关节Harris评分。结果患者均获得随访,时间6~60个月。手术时间、术中出血量、切口长度、住院时间及骨折愈合时间观察组均明显短(少)于对照组(P <0.01)。术后并发症发生率观察组明显低于对照组(P <0.05)。术后3、6个月Harris评分两组均较术前明显提高(P <0.05),观察组均明显高于对照组(P <0.01)。结论与DHS相比,采用PFNA治疗股骨转子间骨折更安全、可靠,更有助于骨折愈合及关节功能恢复,是一种较为理想的手术方法。

Objective To compare the efficacy of proximal femoral nail antirotation( PFNA) and dynamic hip screw( DHS) in the treatment of femoral intertrochanteric fracture. Methods Sixty cases with femoral intertrochanteric fractures were divided into observation group( which received PFNA treatment) and control group( which received DHS treatment),according to different internal fixation methods,with 30 cases in each group. The following data were recorded in the two groups,including the operation time,intraoperative blood loss,incision length,hospitalization time,postoperative complications,fracture healing time,and Harris score of hip joint at pre-operation and post-operation. Results All the cases were followed up for 6 ~ 60 months. Operation time,intraoperative blood loss,incision length,hospitalization time and fracture healing time in the observation group were significantly shorter( less) than those in the control group( P < 0. 01),and the postoperative complications incidence rate in the observation group was significantly lower than that in the control group( P < 0. 05). At 3,6 months after the operation,the Harris scores of the two groups were significantly increased than the preoperation( P < 0. 05),and the score of observation group were significantly higher than that of control group( P < 0. 01). Conclusions Compared with DHS,PFNA is safer and more reliable in the treatment of femoral intertrochanteric fracture,which is helpful for fracture healing and recovery of joint function. It is an idealer operation method.