PFNA和DHS治疗老年股骨粗隆间骨折的临床研究.docxVIP

PFNA和DHS治疗老年股骨粗隆间骨折的临床研究 拉华欠李建明阚玉华 (新疆克拉玛依市中心医院骨一科 新疆 克拉玛依834000) 【摘要】目的：探讨应用防旋型股骨近端髓内钉(PFNA)及动力骯螺钉(DHS) 治疗老年股骨粗隆间骨折的临床效果。方法：回顾分析2005年1月至2011年 12月间95例行手术治疗的老年股骨粗隆间骨折的临床资料，其中防旋型股骨近 端髓内钉(PFNA) 45例(PFNA组)，动力髓螺钉(DHS) 50例(DHS组)；比较 两组患者的手术时间、切口长度、X线暴露次数、术中平均出血量、平均骨折愈 合时间、术后并发症及骯关节功能。结果：PFNA组平均手术时间、术中出血量、 切口长度、术后下地时间及骨折愈合时间方面明显低于DHS组，差异具有显著 的统计学意义(Plt;0.01)；两组在X线暴露次数PFNA组明显高于DHS组，差异 具有统计学意义(Plt;0.05)；两组在手术时间、Harris法骯关节功能评定方面差异 无明显的统计学意义(Pgt;O.05)； PFNA组发生2例股骨干骨折,1例髓内翻，1 例内固定失效；DHS组发生1例股骨干骨折，4例髓内翻，3例内固定失效；两 组并发症发生情况无明显的统计学差异(Pgt;O.05)o结论：应用DHS和PFNA治 疗老年股骨粗隆间骨折，在疗效方面无明显差异。PFNA治疗股骨粗隆间骨折较 DHS具有操作简单、出血少、手术时间短、下地时间早、并发症少等特点，PFNA 对骨折端的血液循环影响和骨质破坏较小，固定更为牢靠，是治疗老年股骨粗隆 间骨折的合理手术方法。 【关键词】老年；股骨粗隆间骨折；动力髓螺钉；防旋型股骨近端髓内钉 【中图分类号】R683 【文献标识码】A 【文章编号】2095-1752 (2016) 25-0025-03 Clinical study of DHS and PFNA treatment of femoral intertrochanteric fracture La Huaqian, Li Jianming, Kan Yuhua. Central Hospital of Kara may City, Xinjiang, Kara may 834000, China [Abstract] Objective Type application anti spin proximal femoral intramedullary nail (PFNA) and dynamic hip screw (DHS) for treatment of senile femoral intertrochanteric fracture. Methods Retrospective analysis in January 2005 to December 2011 to our hospital from 95 surgical treatment of elderly patients with femoral intertrochanteric fracture of clinical data. Results For the average operation time, intraoperative blood loss, length of incision, postoperative down time and fracture healing time, PFNA group was lower than that in group DHS, statistically significant difference (P lt; 0.01). Conclusions Application of DHS and PFNA treatme nt of senile femoral intertrocha nteric fracture, no obvious d iff ere nee in curative effect. PFNA has simple operation, less bleeding, shorter operation time, less down time, early complication etc. PFNA effect on fracture on the circulation of the blood and bone destruction is lesser, fixed more secure. 【Key words] The elderly; Intertrochanteric fracture;Dynamic hip screw; The spiral type proximal femor