DHS、PFNA和股骨近端锁定钢板内固定治疗股骨粗隆间骨折的疗效、预后及安全性比较.docVIP

DHS、PFNA和股骨近端锁定钢板内固定治疗股骨粗隆间骨折的疗效、预后及安全性比较 　　【摘要】 目的：探讨动力髋螺钉系统（DHS）、股骨近端防旋髓内钉（PFNA）和股骨近端锁定钢板（LPFP）内固定治疗股骨粗隆间骨折的疗效、预后及安全性，为股骨粗隆间骨折内固定方法的选择提供依据。方法：选取2011年5月-2014年5月拟于本院行手术治疗的股骨粗隆间骨折患者150例，按手术内固定方法将其分为DHS组、PFNA组和LPFP组，每组各50例。比较三组患者的手术情况、髋关节功能恢复情况、近期和远期预后情况及并发症发生情况。结果：DHS组和LPFP组的手术情况、髋关节功能恢复情况、近期和远期预后情况及并发症发生情况的比较差异均无统计学意义（P0.05）。与PFNA组比较，DHS组和LPFP组的手术时间、住院时间、术后早期功能锻炼时间和骨折愈合时间均较长，术中出血量则较多，术后1个月和3个月的Harris评分及Harris评分优良率均较低，差异均有统计学意义（P0.05）。结论：PFNA内固定较DHS、LPFP等其他内固定治疗股骨粗隆间骨折疗效更佳，可更好地促进髋关节功能恢复和改善近期和远期预后且不会增加术后并发症的发生，具有良好的可行性和安全性，值得临床推广使用。 　　【关键词】 股骨粗隆间骨折； DHS； PFNA； 股骨近端锁定钢板内固定； 疗效； 预后 　　【Abstract】 Objective：To investigate the curative effect，prognosis and safety of dynamic hip screw（DHS），proximal femoral intramedullary nail（PFNA） and locking proximal femoral plate（LPFP） internal fixation for the treatment of femoral trochanter fracture，and provide the reference for the choice of internal fixation methods of femoral trochanter fracture.Method：150 patients with femoral trochanter fracture who needed surgical treatment in our hospital from May 2011 to May 2014 were selected and divided into the DHS group，the PFNA group and the LPFP group according to surgical internal fixation method，50 cases in each group.The operation situation，hip function recovery，immediate and long-term prognosis and complications of three groups were compared.Result：The operation situation，hip function recovery，immediate and long-term prognosis and complications of the DHS group and LPFP group had no statistical significant differences（P0.05）.Compared with PFNA group，the operation time，hospital stay，postoperative early functional exercise time and fracture healing time of DHS group and LPFP group were significantly longer，the intraoperative blood loss amount were significantly increased，and postoperative 1 month and 3 months Harris score and the excellent rate of Harris score were significantly lower，the differences were statistically significant（P0.05）.Conclusion：Compared with DHS and LPFP and o