摘要
目的比较防旋股骨近端髓内钉（PFNA）和动力髋螺钉（DHS）治疗股骨转子间骨折的临床疗效。方法121例股骨转子间骨折患者随机化采用PFNA（n=58例，PFNA组）和DHS（n=63例，DHS组）治疗。记录两组透视时间、手术时间、术中出血量、住院天数、下地行走时间、骨折愈合时间、并发症情况，并进行Harris评分。结果121例均获随访，时间1～3年。手术时间：PFNA组38—70（52±10）min，DHS组45～125（93±13）min，P=0．002。透视时间：PFNA组5～10（7±3）min，DHS组2～7（5±2）min，P=0．003。出血量：PFNA组60-210（156±24）ml，DHS组350～720（410±65）ml，P=0．008。下地时间：PFNA组4～9（6．2±1．5）周，DHS组6—10（8．7±1．3）周，P=0．001。住院天数：PFNA组7～13（9．8±2．4）d，DHS组7—12（9．2±2．7）d，P=0．671。骨折愈合时间：PFNA组7～12（9．8±2．3）周，DHS组7—11（9．3±2．4）周，P=0．486。术后并发症发生率：PFNA组1．7％，DHS组6．3％，P=0．071。临床优良率：PFNA组87．9％，DHS组92．1％，P=0．785。结论PFNA和DHS治疗股骨转子间骨折，均能取得满意的临床疗效，但是PFNA创伤较小，再手术率较低。
Objective To compare the outcome of proximal femoral nail antirotation （PFNA） or dynamic hip screws （DHS） in the treatment of intertrochanteric fractures. Methods 121 patients with intertrochanteric fractures were randomized to treat with PFNA （n = 58, PFNA group） or DHS （ n = 63, DHS group）. These data of the both group were recorded, including the operative time, blood loss, fluoroscopy time, length of hospital stay, walking time, u- nion time, complications, and Harris score. Results All of 121 patients were followed up for 1 ~ 3 years. There were significant difference between the both groups in term of the operative time：PFNA group 38 - 70 （52 ± 10） min, DHS group 45 - 125（93±13） min,P =0. 002. Fluoroscopy time： PFNA group 5 - 10 （7 ±3） min, DHS group 2 - 7（5 ±2） min,P =0. 003. Blood loss： PFNA group 60-210 （ 156 ±24） ml, DHS group 350 -720 （410 ±65） ml, P=0.008. Walking time： PFNA group4 -9 （6.2 ±1.5） weeks, DHS group6 -10 （8.7 ±1.3） weeks,P= 0. 001. There were no significant difference between the two groups in term of the length of hospital stay PFNA group 7 - 13（9. 8 ±2. 4） days, DHS group 7 - 12 （9.2 ±2. 7） days,P =0. 671. Union time： PFNA group 7 - 12 （9. 8 ±2. 3 ） weeks, DHS group 7 -11 （9. 3 ±2.4） weeks,P = 0. 486. Complications rate ： PFNA group 1.7%, DHS group 6. 3% ,P =0. 071. The incidence of good to excellent clinical outcomes： PFNA group 87. 9% , DHS group 92. 1% ,P =0. 785. Conclusions Many patients with intertrochanteric fractures can achieve good to excellent outcomes in treatment of the PFNA or DHS, but the PFNA has more advantages in less iniury and low reooeration rate.
出处
《临床骨科杂志》
2014年第2期161-164,共4页
Journal of Clinical Orthopaedics
关键词
股骨转子间骨折
防旋股骨近端髓内钉
动力髋螺钉
intertrochanteric fracture
proximal femoral nail antirotation
dynamic hip screw
