摘要
目的比较动力髋螺钉(DHS)、股骨近端防旋髓内钉(PFNA)、InterTan髓内钉内固定治疗老年不稳定股骨粗隆间骨折的临床疗效。方法回顾性分析自2014-01—2016-02诊治的300例老年不稳定股骨粗隆间骨折,DHS组100例,PFNA组120例,InterTan组80例。比较3组手术时间、术中出血量、住院时间、骨折愈合时间,术后3、6、12个月髋关节功能Harris评分,以及并发症发生率。结果 300例均获得至少12个月随访。PFNA组、InterTan组手术时间比DHS组长,而InterTan组手术时间比PFNA组更长;PFNA组、InterTan组术中出血量比DHS组少,且PFNA组术中出血量比In-terTan组更少;PFNA组、InterTan组骨折愈合时间、住院时间比DHS组短,术后3、6、12个月髋关节功能Harris评分高于DHS组,术后并发症发生率低于DHS组,差异均有统计学意义(P <0.05)。PFNA组与InterTan组骨折愈合时间、住院时间、术后髋关节功能Harris评分、术后并发症发生率比较差异无统计学意义(P>0.05)。结论 PFNA与InterTan内固定治疗老年不稳定股骨粗隆间骨折的疗效优于DHS内固定,闭合复位髓内固定手术创伤小,可为骨折愈合提供稳定的环境,更有利于术后患者早期进行功能锻炼。但是目前InterTan髓内钉内固定治疗不稳定股骨粗隆间骨折的疗效是否优于PFNA内固定需要进一步随访观察。
Objective To compare the clinical curative effects of dynamic hip screw(DHS),proximal femoral nail antirotation(PFNA)and InterTan intramedullary nailing internal fixation on unstable femoral intertrochanteric fractures of the elderly.Methods A retrospective study was performed on 300 elderly patients with unstable femoral intertrochanteric fractures from January 2014 to February 2016,including 100 patients in the DHS group,120 in the PFNA group and 80 in the InterTan group.The operation time,intraoperative blood loss,hospitalization time,fracture healing time,hip function Harris score at 3,6 and 12 months after operation,and incidence of complication were compared among the three groups.Results All of the patients were followed up for at least 12 months.The operation time of PFNA group and InterTan group was longer than that of DHS group,while the operation time of InterTan group was much longer than that of PFNA group.The intraoperative blood loss of PFNA group and InterTan group was less than that of DHS group,and the intraoperative blood loss of PFNA group was much less than that of InterTan group.The fracture healing time and hospitalization time of PFNA group and InterTan group were shorter than those of DHS group,while the hip function Harris score at 3,6 and 12 months after operation was higher than that of DHS group.The incidence of postoperative complication of PFNA group and InterTan group was lower than that of DHS group(P<0.05).There was no significant difference in fracture healing time,hospitalization time,postoperative hip function Harris score and incidence of postoperative complication between the PFNA group and the InterTan group(P>0.05).Conclusion The curative effect of PFNA and InterTan internal fixation is better than that of DHS internal fixation on unstable femoral intertrochanteric fracture of the elderly.Closed reduction intramedullary nailing internal fixation have less trauma,can provide a stable environment for fracture healing,which is more conducive to early function exercise after s
作者
罗成辉
符江
LUO Chen-hui;FU Jiang(Department of Orthopedics,the Second People's Hopital of Yi Autonomous Prefecture,Xichan,Sichuan 615000,China)
出处
《中国骨与关节损伤杂志》
2019年第2期138-141,共4页
Chinese Journal of Bone and Joint Injury
关键词
不稳定股骨粗隆间骨折
动力髋螺钉
股骨近端防旋髓内钉
InterTan髓内钉
内固定
老年
Unstable femoral intertrochanteric fracture
Dynamic hip screw
Proximal femoral nail antirotation
InterTan intramedullary nailing
Internal fixation
Elderly
