动力髋螺钉与股骨近端抗旋髓内钉两种内固定方式对老年股骨粗隆间骨折治疗优良率及并发症的影响

Effects of Two Internal Fixation Methods,Dynamic Hip Screw and Proximal Femoral Nail Antirotation,on the Treatment Excellence Rate and Complications of Intertrochanteric Fracture of Femur in Elderly People

目的在临床中针对老年股骨粗隆间骨折分析动力髋螺钉(dynamic hip screw,DHS)与股骨近端抗旋髓内钉(proximal femoral nail antirotation,PFNA)治疗的临床结果。方法对2020年1月—2022年6月江苏省高邮市中西医结合医院收治的84例老年股骨粗隆间骨折患者的临床资料进行回顾性分析。其中DHS内固定42例为DHS组,PFNA内固定42例为PFNA组。临床研究指标有手术时间、住院时间和术中出血量,还同时包括骨折愈合时间、治疗优良率和并发症。结果PFNA组手术时间、骨折愈合时间、住院时间较DHS组短,PFNA组术中出血量较PHS组少,差异有统计学意义(P<0.05)。术后PFNA组治疗优良率95.24%明显优于DHS组的80.95%,差异有统计学意义(χ^(2)=4.086,P<0.05)。PFNA组手术并发症发生率低于DHS组,差异无统计学意义(P>0.05)。结论PFNA作为一种新型的髓内固定系统,与DHS相比,具有创伤小、手术时间短、缩短骨折愈合时间等优点,还可进一步改善髋关节功能。

Objective To analyze the clinical results of dynamic hip screw(DHS)and proximal femoral nail antirotation(PFNA)in the treatment of intertrochanteric fracture of femur in the elderly.Methods The clinical data of 84 cases of elderly patients with intertrochanteric fracture of femur admitted to Gaoyou Integrated Hospital of Traditional Chinese and Western Medicine from January 2020 to June 2022 were retrospectively analyzed.Among them,42 cases of DHS internal fixation were in the DHS group and 42 cases of PFNA internal fixation were in the PFNA group.The clinical study indicators were operation time,hospitalization time and intraoperative bleeding.Fracture healing time,treatment excellence rate and complications were also included at the same time.Results The operation time,fracture healing time,and hospitalization time in the PFNA group was shorter than those in the DHS group,and the intraoperative bleeding volume in PFNA group was less than that in the DHS group,and the difference was statistically significant(P<0.05).The postoperative treatment excellence rate of 95.24%in the PFNA group was significantly better than 80.95%in the DHS group,and the difference was statistically significantly(χ^(2)=4.086,P<0.05).The incidence of surgical complications in the PFNA group was lower than that in the DHS group,but the difference was not statistically significant(P>0.05).Conclusion PFNA,as a new intramedullary fixation system,has the advantages of less trauma,shorter surgical time and shorter fracture healing time compared with DHS,and it can also further improve the function of the hip joint.