摘要
目的比较PFNA(股骨近端防旋髓内钉)和DHS(动力髋螺钉)内固定治疗老年股骨粗隆间骨折的疗效。方法随机选取2015年1月—2017年8月收治的65例老年股骨粗隆间骨折患者,依据随机数字表法分为实验组(33例)与对照组(32例),分别采取PFNA和DHS内固定治疗,对比术后康复效果、手术指征、术后并发症发生率。结果实验组术后康复优良率(97.0%)较对照组(81.3%)更高(χ~2=4.178,P=0.041),术后髋关节Harris评分(91.4±6.1)分,较对照组更高(t=5.174,P=0.000),切口长度(10.8±2.1)cm较对照组更小(t=6.512,P=0.000),术中出血量(181.3±24.7)m L和术后引流量(54.8±9.9)mL较对照组更少(t=13.359,13.597,P=0.000),手术时间(69.2±7.7)min、负重时间(5.5±1.2)周、骨折愈合时间(10.4±1.5)周、术后住院时间(15.0±3.0)d较对照组更短(t=6.723,5.881,8.809,4.605,P=0.000),术后并发症发生率(6.1%)较对照组(25.0%)更低(χ~2=4.477,P=0.034)。结论 PFNA内固定相比DHS内固定在治疗老年股骨粗隆间骨折中更具优势,术后康复速度更快、并发症更少,更适宜在临床中推广应用。
Objective To compare the curative effect of PFNA and DHS internal fixation in treatment of senile intertrochanteric fracture. Methods 65 cases of senile intertrochanteric fracture patients admitted and treated in our hospital from January 2015 to August 2017 were selected and randomly divided into two groups, the experimental group with 33 cases and the control group with 32 cases were respectively treated with PFNA and DHS internal fixation, and the postoperative recovery effect, operative signs and incidence rate of complications after surgery were compared between the two groups. Results The rehabilitation excellent and good rate after surgery in the experimental group was higher than that in the control group （97.0% vs 81.3%）（χ^2=4.178, P=0.041） , and the Harris score of hip joint after surgery was higher than that in the control group, which was（91.4±6.1）points（t=5.174, P=0.000） , and the incision length was （10.8±2.1）points, which was smaller than that in the control group（t=6.512, P=0.000） , and the intraoperative bleeding amount and postoperative drainage amount were lower than those in the control group, which were respectively （181.3±24.7）mL and （54.8±9.9）mL（t=13.359,13.597, P=0.000） , and the operative time, loading time, fracture healing time and postoperative length of stay were shorter than those in the control group, which were respectively（69.2±7.7）min, （5.5±1.2）weeks, （10.4±1.5）weeks, （15.0±3.0）d,（t=6.723, 5.881,8.809,4.605, P=0.000） , and the incidence rate of postoperative complications was lower than that in the control group （6.1% vs 25.0%）（χ2=4.477, P=0.034）. Conclusion The PFNA has more advantages in treatment of senile intertrochanteric fracture than DHS internal fixation, and the postoperative recovery rate is rapider, and the complications are fewer, and it is more suitable for the clinical promotion and application.
作者
黄晓东
戚文元
HUANG Xiao-dong;QI Wen-yuan(Department of Orthopedics and Traumatology,Jiangyin Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangyin,Jiangsu Province,214400 China)
出处
《中外医疗》
2018年第32期34-36,共3页
China & Foreign Medical Treatment
关键词
股骨粗隆间骨折
股骨近端防旋髓内钉
动力髋螺钉
Intertrochanteric fracture
Proximal femoral nail anti rotation
Dynamic hip screw
