股骨近端防旋髓内钉、加压滑动鹅头钉和股骨近端锁定加压钢板治疗股骨粗隆间骨折的疗效比较

摘要

Objective To explore the clinical effects of PFNA(proximal femoral nail anti-rotation)DHS(dynamic hip screw)and PFLP(proximal femoral locking compression plate)for the treatment of intertrochanteric fracture.Methods Data of 130 patients with unstable intertrochanteric fractures were retrospectively analyzed.The patients were assigned into three groups according to the different methods of operation:PFNA group with 45 cases,DHS group with 50 cases,and PFLP group with 35 cases.The surgical incision,opera-tion time,intraoperative blood loss,postoperative complications,postoperative hip joint function recovery,postoperative fracture healing time were respectively observed.Results Compared with DHS and PFLP groups,there were statistical differences in incision,operation time,intraoperative blood loss,and postoperative hip joint function recovery in PFNA group(P <0.05),while there was no statistical difference in fracture healing time in PFNA group(P >0.05).During postoperative follow-up,there were no complications in PFNA group,one screw out in DHS group,and one steel plate fracture in PFLP group.Conclusions PFNA was obviously better than DHS and PFLP in the treatment of unstable intertrochanteric fractures in elderly patients,which was worth popularizing in clinical treatment.%目的：探讨股骨近端防旋髓内钉（PFNA）、加压滑动鹅头钉（DHS）和股骨近端锁定加压钢板（PFLP）治疗股骨粗隆间骨折的临床疗效。方法回顾性分析130例老年股骨粗隆间骨折患者的临床资料，根据手术方式的不同分为三组：PFNA 组45例，DHS 组50例，PFLP 组35例，分别观察手术切口，手术时间，术中出血量，术后并发症发生率，术后髋关节功能恢复情况，术后骨折愈合时间等。结果PFNA 组在手术切口，手术时间，术中出血量，术后髋关节功能恢复情况方面，与 DHS 和 PFLP 组比较差异有统计学意义（P ＜0．05），在骨折愈合时间方面比较差异无统计学意义（P ＞0．05）。术后随访过程中，PFNA 组无一例并发症，DHS 组有一例螺钉退钉，PFLP 组有一例钢板断裂。结论PFNA 在治疗老年不稳定性股骨粗隆间骨折患者方面明显优于 DHS 和 PFLP 组，在临床治疗中值得广泛推广。