不同内固定方法治疗老年股骨转子间骨折的疗效评价

摘要

目的 评价动力髋螺钉(DHS)和股骨近端髓内钉(PFN)治疗老年股骨转子间骨折的疗效.方法 对笔者医院收治的178例股骨间转子骨折患者的临床资料进行回顾性分析.比较采用DHS固定(98例)和PFN固定(80例)的患者手术时间、手术出血量、术后引流量、固定效果及术后并发症发生情况.结果 PFN组的手术时间(t=25.301,P=0.000)、术中出血量(t=55.093,P=0.000)、术后引流量(t=119.581,P=0.000)和术后并发症发生率(x2=4.298,P=0.038)均低于DHS组.两组间的固定效果存在差异(Z=2.005,P=0.045),PFN组的固定效果优于DHS组,固定效果优良率分别为PFN组88.8％,DHS组76.5％.结论 PFN内固定法在治疗老年股骨转子间骨折的过程中取得了较好的效果,相对于DHS内固定具有手术时间短、术中出血量少、术后并发症少的优点,具有较高的临床应用价值.%Objective To assess the effects of dynamic hip screw (DHS) and proximal femoral nail (PFN) on femoral intertrochanteric fracture among old patients. Methods The clinical data of 178 patients with femoral intertrochanteric fracture were analyzed. We compared time of operation, loss of blood, amount of drainage, effect of fixation, and incidence of postoperative complications between DHS (n= 98) and PFN (n = 80). Results The time of operation (t = 25. 301, P = 0. 000), loss of blood (t = 55. 093, P = 0. 000), amount of drainage (t =119. 581, P = 0. 000), and the incidence of postoperative complications (x2= 4. 298, P = 0. 038) in the PFN group was lower than thosed in the DHS group. The effect of fixation of PFN (Z = 2. 005, P= 0.045) was superior to the effect of DHS. The effective rates of PFN and DHS were 88. 8% and 76. 5%, respectively. Conclusion PFN is associated with a less time of operation, loss of blood, and postoperative complications, compared with DHS in treatment of femoral intertrochanteric fracture among old patients-The fixation of PFN is deserved to be implemented in clinical setting.