摘要
摘要目的探讨股骨近端防旋髓内钉和动力髋螺钉对老年股骨粗隆间骨折的治疗效果.方法选取我院２０１３年１月至２０１５年１月收治的股骨粗隆间骨折患者９８例进行研究,根据随机和患者意愿相结合的方式,将９８例患者分为PFNA组(n＝５０例)和DHS组(n＝４８例).PFNA组采用股骨近端防旋髓内钉治疗,DHS组采用动力髋螺钉治疗.观察两组切口长度、操作时间、术中出血量、下地时间、术后并发症、骨折愈合时间及并发症发生率,随访６个月时对两组进行Harris评分,评定临床治疗效果.结果PFNA组手术时间、切口长度、术中出血量、术后下地时间、骨折愈合时间等均小于DHS组,且差异均有显著统计学意义(p＜０．０１).两组优良率比较,PFNA组优于DHS组,差异有统计学意义(p＜０．０５).DHS组发生压疮４例,髋内翻２例,内固定松动１例,下肢深静脉血栓２例,发生率为１８．７５％;PFNA组发生内固定松动１例,下肢静脉血栓１例,发生率为４％,两组比较χ２＝５．３４７,p＜０．０５.结论PFNA治疗具有创伤小,固定可靠,术后并发症少等优点,在老年股骨粗隆间骨折治疗上有着明显的优势,具有较高的临床推广价值.关键词股骨粗隆间骨折;股骨近端防旋髓内钉;动力髋螺钉Thecomparativeanalysisofanti－rotationofproximalfemoralnaiandthedynamichipscrewinelderlyintertrochantericfractureKongDequn(DevelopmentofOrthopaedics,People＇sHospitalofTaixingCity,TaixingCity,JiangsuProvince,２２５４９９,China)AbstractObjectiveTostudythetreatmenteffectofanti－rotationofproximalfemoralnail(PFNA)andthedynamichipscrew(DHS)inelderlyintertroＧchantericfracture．Methods９６elderlypatientswithintertrochantericfractureselectedfromJanuary２０１３toJanuary２０１５weredividedintothePFNAgroup(n＝５０cases)andDHSgroup(n＝４８cases)byrandomizedprincipleandpatientwill．ThepatientsinPFNAgroupweretreatmentwithanti－rotationofproximalfemoralnail,whilethepatientsinDHSgroupweretreatmentwiththedynamichipscrew．Theincisionlength,operationtime,intraoperativebloodloss,timeofgettingoutbed,postoperativecomplications,fracturehealingtimeandcomplicationratewereobserved．TheclinicaleffectoftwogroupswasevaluatedwithHarＧrisscore．ResultsTheoperationtime,incisionlength,intraoperativebloodloss,timeofgettingoutbedandfracturehealingtimeofpatientsinPFNAgroupwerelowerthanthoseofpatientsinDHSgroup,whichwerestatisticallysignificant(p＜０．０１)．TheexcellentandgoodrateofPFNAgroupwasbetterthanDHSgroup,whichwasstatisticallysignificant(p＜０．０５)．ThecomplicationrateofDHSgroupwas１８．７５％(４patientswithpressuresore,２patientswithcoxavara,１patientinternalfixationloosening,２patientswithlowerlimbdeepvenousthrombosis)andcomplicationrateofPFNAgroupwas４％(１patientinternalfixationloosening,１patientwithlowerlimbdeepvenousthrombosis),whichwerestatisticallysignificant(χ２＝５．３４７,p＜０．０５)amongtwogroup．ConclusionPFNAinthetreatmentofelderlyintertrochantericfracturewasbetterthanDHSwithadvantagesofminimallyinvasive,fixedfirmlyaftersurgery,lessposterativecompliＧcationsK,eywhwiocrhdsisworthyofclinicalapplication．IntertrochantericFracture;Anti－RotationofProximalFemoralNail;DynamicHipScrew中图分类号R６８７．３文献标识码B文章编号１００８－６３１５(２０１５)１０－０４４５－０２
出版日期
2015年09月19日（中国期刊网平台首次上网日期，不代表论文的发表时间）
