DHS、PFN与FHR治疗不稳定性股骨粗隆间骨折临床效果比较.docVIP

DHS、PFN与FHR治疗不稳定性股骨粗隆间骨折临床效果比较 　　[摘要] 目的 探讨DHS、PFN及FHR治疗不稳定性股骨粗隆间骨折的效果。方法 运用随机数字表法将2010年7月～2011年7月本院骨科住院治疗的189例不稳定性股骨粗隆间骨折患者分为DHS治疗组、PFN治疗组及FHR治疗组，对各组患者进行相应治疗后，采用髋关节功能Harris评分系统评定各组患者临床疗效。 结果 FHR治疗组患者在手术时间、术中出血及髋关节功能上，均明显高于DHS治疗组及PFN治疗组患者，差异有统计学意义（P ＜ 0.05）。结论 FHR治疗不稳定性股骨粗隆间骨折患者所需手术时间短，术中出血较少，术后髋关节功能恢复较好，是临床治疗不稳定性股骨粗隆间骨折的一种安全有效的方法，值得在临床中推广应用。 　　[关键词] 股骨粗隆间骨折；动力髋螺钉；股骨近端髓内钉；人工股骨头置换术 　　[中图分类号] R683.42 [文献标识码] A [文章编号] 1674-4721（2012）02（a）-0019-03 　　 　　A comparison study of DHS, PFN and FHR treatment on femoral intertrochanteric fracture 　　FAN Fei WANG Yuwei JIA Lianjun WANG Zhihui 　　Department of Orthopedics Two of the Third Hospital of Datong City in Shanxi Province, Datong 037008, China 　　[Abstract] Objective To evaluate the clinical results of unstable intertrochanteric fracture treatment with DHS, PFN and femoral head replacement. Methods One hundred and eighty-nine patients who were diagnosed with femoral intertrochanteric fractures were divided into DHS group, PFN group and femoral head replacement group using a random number table. The patients were performed with DHS, PFN and Femoral head replacement, respectively. The clinical results were evaluated according to the Harris score system. Results Femoral head replacement group were more than other groups in operation time, blood loss and hip function (P ＜ 0.05). Conclusion Femoral head replacement is a safe and effective method with good clinical results in treatment of unstable femoral intertrochanteric fracture in elder patients, which can decrease operation time, blood loss as well as better functional recovery of hip, it is worthy of clinical application. 　　[Key words] Femoral intertrochanteric fracture; Dynamic hip screws; Proximal femoral nail; Femoral head replacement 　　 　　股骨粗隆间骨折多见于65岁以上的老年人，是老年人常见的骨折类型之一。我国进入老龄化社会以来，老年人口明显增加，人均寿命明显延长，骨质疏松的人口也明显增加，这无疑导致股骨粗隆间骨折的发生率也明显增加。患者发生股骨粗隆间骨折后，不仅给患者的生活、学习及工作带来显著的影响，严重者甚至危及患者的生命，而且给患者家庭及社会造成重大的精神压力和经济压力[1]。而目前对于股骨粗隆间骨折的治疗方式首选手术治疗，对股骨粗隆间骨折患者可采用的手术方式较多，但是每种