摘要
目的比较动力髋螺钉(DHS)、股骨近端抗旋髓内钉(PFNA)、单臂外固定架技术(SEFT)治疗老年股骨粗隆间骨折的临床效果。方法选取本院于2013年11月至2016年11月收治的203例老年股骨粗隆间骨折患者,113例DHS,55例PFNA,35例SEFT。对比3组手术时间、住院时间、出血量、患髋功能、并发症等。结果术后对患者开展6～12个月随访,DHS组住院时间(14.2±2.6)d,手术时间(102.3±22.6)min,出血量(240.7±38.3)ml,术后3个月Harris评分(88.6±12.7)分;PFNA组依次为(11.1±3.3)d、(50.2±15.5)min、(80.4±18.6)ml、(92.5±15.3)分;SEFT组(15.0±3.2)d、(35.7±10.8)min、(52.5±12.8)ml、(84.2±12.5)分;3组两两比较,差异具有统计学意义(P<0.05),但骨折愈合时间对比差异无统计学意义。DHS组并发症数最多,PFNA最少(P<0.05)。结论 DHS对骨折较稳定且身体状况良好者较适用。SEFT对于身体状况差,且无法耐受麻醉时间长、创伤大与出血多患者更适用。PFNA损伤小,且固定牢固,术后有较低的术后并发症,对于多种骨折类型均适用,更适合治疗老年股骨粗隆间骨折。
Objective To compare the clinical effects of dynamic hip screw (DHS), proximal femoral anti-rotation intramedullary nail (PFNA) and single arm external fixator (SEFT) in the treatment of intertrochanteric fracture in the elderly. Methods 203 elderly patients with intertrochanteric fracture of femur, 113 cases of DHS, 55 cases of PFNA and 35 cases of SEFT were selected from November 2013 to November 2016. The operation time, hospitalization time, blood loss, hip function and complications were compared among the three groups. Results The patients were followed up for 6 to 12 months after operation. The hospitalization time, operation time, bleeding volume and Harris score in DHS group were (14.2± 2.6) days,(102.3±22.6) minutes and (240.7±38.3) ml respectively. The Harris score was (88.6±12.7) points in three months after operation. The PFNA group was (11.1±3.3) days,(50.2±15.5) minutes,(80.4±18.6) ml and (92.5±15.3) ml respectively. The scores of SEFT group were (15.0±3.2) d,(35.7±10.8) min,(52.5±12.8) ml,(84.2±12.5) points. There was a significant difference between the two groups (P<0.05), but there was no significant difference in healing time. Complications were the most in DHS group and the least in PFNA group (P<0.05). Conclusion DHS is more suitable for patients with stable fracture and good physical condition. SEFT is more suitable for patients with poor physical condition, long anesthesia time, severe trauma and bleeding. PFNA has less injury, firm fixation and lower postoperative complications. It is suitable for various types of fractures and is more suitable for the treatment of intertrochanteric fracture of femur in the elderly.
作者
王智华
Wang Zhihua(Fuzhou First People's Hospital, Fuzhou, Jiangxi, 344000, China)
出处
《当代医学》
2019年第8期69-71,共3页
Contemporary Medicine
关键词
股骨粗隆间骨折
老年
动力髋螺钉
股骨近端抗旋髓内钉
Femoral intertrochanteric fracture
Old age
Dynamic hip screw
Proximal femoral anti-rotation intramedullary nail
