摘要
目的比较采用股骨近端防旋髓内钉（PFNA）、动力髋（DHS）、股骨近端锁定钢板（PFLP）内固定治疗高龄股骨转子间骨折的临床疗效。方法 89例高龄（≥75岁）股骨转子间骨折患者按治疗方法分为3组：PFNA组25例,DHS组38例,PFLP组26例。比较3组的手术时间、术中出血量、骨折愈合时间、术后内固定并发症、髋关节功能。末次随访按Harris评分评价疗效。结果 89例均获随访,时间12～24（14.0±2.8）个月。PFNA组较DHS组、PFLP组骨折愈合时间短（P〈0.05）,DHS组及PFLP组并发症较PFNA组高（P〈0.05）。DHS组与PFNA组、PFLP组手术时间、术中出血量比较差异有统计学意义（P〈0.05）。3组患者均未出现切口感染,出现1例下肢深静脉血栓形成,3例术后肺部感染,均经治疗后治愈。髋关节功能Harris评分：PFNA组：优19例,良4例,可1例,差1例,优良率23/25（92.0%）;DHS组：优22例,良8例,可5例,差3例,优良率30/38（78.9%）;PFLP组：优10例,良8例,可4例,差4例,优良率18/26（69.2%）。结论 3种内固定方法比较,PFNA治疗高龄股骨转子间骨折手术创伤小,固定牢固,骨折愈合时间短,术后发生内固定并发症少,可早期下地负重,髋关节功能好,治疗效果满意。
Objective To compare the clinical effects among elderly patients with intertrochanteric fracture,which were treated by proximal femoral anti-rotation nail（ PFNA）,dynamic hip screw（ DHS） and proximal femoral locking plate（ PFLP）. Methods 89 elderly patients of femoral intertrochanteric fractures（ ≥75） were divided into 3 groups according to the operation method： PFNA group（ n = 25）,DHS group（ n = 38）,and PFLP group（ n = 26）. The time of surgery,perioperative blood loss,clinical fracture healing time,postoperative complications and hip function were taken as factors and analyzed between three groups. The last follow-up results were assessed with the Harris score evaluation standard. Results 89 cases were followed up for 12 ～ 24（ 14. 0 ± 2. 8） months. There were shorter fracture healing time and lower complication for the treatment of PFNA than other groups（ P〈0. 05）. There were statistical significant difference in operation time,blood loss for DHS group compared with other groups（ P〈0. 05）. No incision infection was reported. There was one case of deep vein thrombosis and 3 cases of postoperative lung infection,which were treated and cured later. For Harris score of hip joint fuction,the results were excellent in 19 cases,good in 4,fair in 1,and poor in 1,and the excellent and good rate in PFNA group was 23 /25（ 92. 0%）,and those in DHS group and PFLP group were 22,8,5,3 and 30 /38（ 78. 9%）,and 10,8,4,4 and 18 /26（ 69. 2%） respectively.Conclusions Compared with 3 kinds of internal fixation methods,PFNA treatment of intertrochanteric fracture is little trauma and firm fixation,fewer complications. PFNA is effective for the elderly patients
出处
《临床骨科杂志》
2015年第1期73-76,共4页
Journal of Clinical Orthopaedics
关键词
骨折固定术
内
骨折固定术
髓内
老年人
股骨骨折
fracture fixation
internal
fracture fixation
intramedullary
aged
femoral fractures
