三种固定方式治疗老年股骨粗隆间骨折的临床比较

目的对比观察三种固定方式治疗老年股骨粗隆间骨折的临床疗效。方法选择我院自2000~2013年共收治的348例采取手术治疗的老年股骨粗隆间骨折患者的临床资料,将患者分为DHS(动力髋螺钉)组、Gamma钉组及PFNA(股骨近端防旋髓内钉)组,对比观察三组患者临床疗效、手术时间、术中出血量及术中、术后并发症发生情况,结果三组患者在术前准备埋单及平均住院时间比较,结果具有明显差异(P>0.05)。DHS组手术时间、出血量明显高于其他两组患者(P<0.05),PFNA组患者手术时间、术中出血量明显短于其他两组(P<0.05),DHS组患者术后并发症发生率明显高于其他两组(P<0.05)。三组患者优良率比较,无明显差异(P>0.05)。结论采用PNFA方法治疗对患者机体的伤害小,可有效预防并发症的发生,是合理且有效的治疗老年股骨粗隆间骨折的方法 ,可优先考虑使用。

Objective Comparison of three fixation methods for the treatment of elderly patients with intertrochanteric fractures of the clinical efficacy.Methods the clinical data of 348 cases of intertrochanteric fractures treated in our hospital from to 2000 were divided into three groups:DHS(dynamic hip screw).Gamma nail and PFNA(proximal femoral nail.Results the three groups were prepared to pay the bill and the average hospitalization time compared before operation,there was significant difference between the result(P>0.05).The operation time and bleeding volume in DHS group were significantly higher than those in other two groups(P<0.05).The operation time and blood loss were significantly shorter than those in the other two groups(P<0.05).and the postoperative complication rate was significantly higher in DHS group than in the other two groups(P<0.05).There was no significant difference between the three groups(P>0.05).Conclusion the use of PNFA method in the treatment of patients with the injury to the body,can effectively prevent the occurrence of complications,is reasonable and effective treatment of elderly femoral intertrochanteric fracture,can give priority to use.