动力髋螺钉与股骨近端防旋髓内钉治疗高龄不稳定股骨转子间骨折的疗效比较

Comparison of effect of dynamic hip screw versus proximal femoral auti rotation intramedullary nail on unstable femoral intertrochanteric fractures in elderly

目的 比较动力髋螺钉(DHS)与股骨近端防旋髓内钉(PFNA)治疗高龄不稳定股骨转子间骨折的效果。方法 选择2019年10月至2021年10月定西市人民医院收治的85例不稳定股骨转子间骨折高龄患者作为研究对象,按交替分组法分为两组。A组42例行动力髋螺钉治疗,B组43例行股骨近端防旋髓内钉治疗。比较两组手术及恢复情况、髋关节Harris评分、术后并发症发生情况。结果 B组手术时间、完全负重时间低于A组(P <0.05)。术后3个月,两组Harris评分中主诉疼痛、运动范围、畸形、功能评分及总分较术前升高,B组主诉疼痛、运动范围、功能评分及总分高于A组(P <0.05)。B组术后并发症发生率(4.65%,2/43)低于A组(21.43%,9/42),差异有统计学意义(P <0.05)。结论 PFNA治疗高龄不稳定股骨转子间骨折具有创伤小、术后恢复快的优势,能有效改善患者髋关节功能,减少术后并发症,明显降低病死率,明显改善生存质量。

Objective To compare the efficacy of dynamic hip screw( DHS) versus proximal femoral auti rotation intramedullary nail( PFNA) on unstable femoral intertrochanteric fractures in elderly.Methods Eighty-five elderly patients with unstable femoral intertrochanteric fracture treated in the People’s Hospital of Dingxi from October 2019 to October 2021 were selected as the research objects. They were divided into two groups according to the alternating grouping method. The 42 patients in group A were treated with dynamic hip screw and the 43 patients in group B were treated with proximal femoral anti rotation intramedullary nail. The operation and recovery,Harris score of hip joint and postoperative complications were compared between the two groups. Results The operation time and complete weight-bearing time in group B were lower than those in group A( P < 0. 05). Three months after operation,the main complaint pain,range of motion,deformity,function score and total score of Harris score in the two groups were higher than those before operation( P < 0. 05). The main complaint pain,range of motion,function score and total score in group B were higher than those in group A( P < 0. 05). The incidence of postoperative complications in group B( 4. 65%,2/43) was lower than that in group A( 21. 43%,9/42,P < 0. 05). Conclusions PFNA has the advantages of less trauma and rapid postoperative recovery in the treatment of unstable femoral intertrochanteric fractures in the elderly. It can effectively improve the hip function and reduce postoperative complications,significantly reduce mortality and improve the quality of life.