老年股骨粗隆间骨折患者用不同手术方法疗效对比

摘要

目的：探讨治疗老年股骨粗隆间骨折伴骨质疏松患者选用不同内固定方法的疗效的比较。方法选取我科患者123例进行回顾性研究,均为2002年1月~2013年1月治疗的老年伴骨质疏松性股骨粗隆间骨折患者,其中40例采用动力髋螺钉(DHS)内固定,41例采用髓内钉固定(PFNA),42例采用股骨近端锁定钢板固定(LCP)。结果120例患者获得随访,时间为10~24个月,平均为17个月。DHS组总有效率为(71.49%),PFNA组总有效率为(80.0%),LCP组总有效率(80.48%),组间比较差异无统计学意义(P>0.05)。在手术时间、功能活动、骨折愈合时间等方面组间存在差异,LCP组与PFNA组明显优于DHS组(P<0.05),而LCP组与PFNA组比较差异无统计学意义。内固定物折断等并发症发生率,三组比较有统计学意义(P<0.05)。结论老年伴骨质疏松性股骨粗隆间骨折采用DHS、PFNA和LCP固定在治疗效果上无明显差异存在,但在手术时间、功能活动、骨折愈合时间等方面LCP组与PFNA组均优于DHS组,而LCP组与PFNA组比较差异无统计学意义。内固定物折断等并发症发生率方面,LCP组优于其余两组,对患者的病情恢复起到更积极的作用。%Objective To explore the treatment of elderly patients with femoral intertrochanteric fractures with osteoporosis choose the comparison of the ef ect of dif erent internal fixation methods. Methods Choose 123 patients with our department were retrospectively study,January 2002~January 2013 treatment of elderly patients with osteoporotic intertrochanteric fractures with,40 cases with dynamic hip screw(DHS)internal fixation,41 cases with intramedul ary nail fixation(PFNA),42 patients with proximal femoral locking plate fixation(LCP).Results 120 patients received fol ow-up,time is 10 to 24 months,an average of 17 months.DHS group total ef ective rate(71.49%),PFNA group total ef ective rate(80.0%),the LCP group total ef ective rate(80.48%),and compare the dif erences between groups have no statistical significance ( >0.05).In operation time,functional activities,fracture healing time and so on the dif erences between the groups,DHS group is obviously bet er than the LCP and PFNA group ( <0.05),the LCP group there was no statistical y significant dif erence compared with PFNA group.Internal fixation broken complications,such as the comparison group was statistical y significant ( <0.05).Conclusion Elderly with osteoporotic intertrochanteric fractures with DHS and PFNA and LCP fixation on the treatment ef ect has no obvious dif erence exists,but the operation time,the functional activities,fracture healing time of LCP and PFNA group were bet er than DHS group,the LCP group there was no statistical y significant dif erence compared with PFNA group. Complications aspects,such as internal fixation broken LCP group is bet er than that of the rest of the two groups,the recovery of the patient have a more active role.