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老年人A2型股骨粗隆间骨折PFNA和DHS固定疗效比较 被引量:23

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摘要 目的探讨抗旋转股骨近端髓内钉(PFNA)和动力髋螺钉(DHS)固定治疗老年人A2型股骨粗隆间骨折的临床疗效和安全性。方法2013年1月至2014年9月,该院应用PFNA和DHS固定治疗58例65岁以上AO分型为A2型的股骨粗隆间骨折患者,PFNA组33例,DHS组25例,对手术时间,出血量、切ISl长度,术后引流量,开始负重时间,并发症,骨折愈合时间和关节功能等指标进行统计。髋关节功能评价采用Harris评价标准。结果PFNA组31例,DHS组24例患者获得随访,随访时间为9.0~15.5个月,骨折临床愈合时间PFNA组(12.5±3.5)W、DHS组(13.5±4.5)W;至末次随访,PFNA组和DHS组髋关节功能评分优良率分别为90.3%和83.3%;股骨近端形态异常发生率PFNA组和DHS组分别为12.9%和33.3%,平均手术时间PFNA组为(40.3±12.7)min,DHS组(85.5±18.6)min;术中出血量PFNA组为(50.2±35.0)ml,DHS组(182.O±76.9)ml;术后引流量PFNA组为(30.5±9.6)mI,DHS组(100.5±10.7)fnJ;手术切口长度PFNA组(4.3±2.7)cm,DHS组(10.5±5.6)cm;开始负重时间PFNA组(10.3±5.7)d,DHS组(30.5±10.6)d。骨折愈合时间和髋关节Harris评分优良率两组无统计学差异,而两组股骨近端形态异常发生率、平均手术时间、术中出血量、术后引流量、切口长度、开始负重时间比较差异显著。结论PFNA和DHS固定治疗老年人A2型股骨粗隆间骨折都能达到理想治疗效果,但PFNA固定较DHS固定方法简便、微创、并发症少,能早期负重活动。
出处 《中国老年学杂志》 CAS CSCD 北大核心 2016年第17期4279-4281,共3页 Chinese Journal of Gerontology
基金 沈阳医学院科技基金项目(No.20141017)
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参考文献10

  • 1Wiltfong RE,Taylor BC,Steensen RN.Lower extremity bypass graft occlusion after intramedullary fixation of intertrochanteric hip fracture on a fracture table[J].Orthopedics,2011;34(5):395.
  • 2Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty[J].J Bone Joint Surg(Am),1969;51(4):737-55.
  • 3Emami M,Manafi A,Hashemi B,et al.Comparison of intertrochanteric fracture fixation with dynamic hip screw and bipolar hemiarthroplasty techniques[J].Arch Bone Jt Surg,2013;1(1):14-7.
  • 4Said GZ,Farouk O,El-Sayed A,et al.Salvage of failed dynamic hip screw fixation of intertrochanteric fractures[J].Injury,2006;37(2):194-202.
  • 5Mardani-Kiri M,Mirbolook A,Khajeh-Jahromi S,et al.Fixation of intertrochanteric fracture:dynamic hip screw versus locking compression plate[J].Trauma,2013;18(2):67-70.
  • 6Avakian Z,Shiraev T,Lam L,et al.Dynamic hip screw versus proximal femoral nails for intertrochanteric fractures[J].ANZ J Surg,2012;82(1-2):56-69.
  • 7Huang H,Xin J,Ma B.Analysis of complications of intertrochantefic fracture treated with Gamma 3 intramedullary nail[J].Int J Clin Exp Med,2014;7(10):3687-93.
  • 8Kazemian GH,Manafi AR,Najafi F,et al.Treatment of intertrochanteric fractures in elderly high risk patients:dynamic hip screw vs.external fixation[J].Injury,2014;45(3):568-72.
  • 9Li J,Xu XZ,You T.Early results of the proximal femoral nail antirotationAsia for intertrochanteric fractures in elderly Chinese patients[J].Saudi Med J,2014;35(4):385-90.
  • 10侯国进,周方,张志山,姬洪全,田耘.不同内固定方式治疗老年股骨粗隆间骨折围手术期的失血特点分析[J].北京大学学报(医学版),2013,45(5):738-741. 被引量:106

二级参考文献14

  • 1Xu Y, Geng D, Yang H, et al. Treatment of unstable proximal femo- ral fractures : comparison of the proximal femoral nail antirotation and gamma nall 3 [J]. Orthopedics, 2010, 33(7) : 473 -478.
  • 2Sehat KR, Evans R, Newman JH. How much blood is really lost in total knee arthroplasty? Correct blood loss management should take hidden loss into account [J]. Knee, 2000, 7(3) : 151 -155.
  • 3Gross JB. Estimating allowable blood loss: corrected for dilution [J]. Anesthesiology, 1983, 58(3) : 277 -280.
  • 4Nadler SB, Hidalgo JH, Bloch T. Prediction of blood volume in normal human adults [ J]. Surgery. 1962. 51(2) : 224 -232.
  • 5Smith GH, Tsang J, Molyneux SG, et al. The hidden blood loss after hip fracture [J]. Injury, 2011,42(2): 133 -135.
  • 6Chechik O, Thein R, Fichman G, et al. The effect of clopidogrel and aspirin on blood loss in hip fracture surgery [ J ]. Injury, 2011,42(11) : 1277 -1282.
  • 7Manning B J, O' Brien N, Aravindan S, et al. The effect of aspirin on blood loss and transfusion requirements in patients with femoral neck fractures [J]. Injury, 2004, 35(2) : 121 -124.
  • 8Foss NB, Kehlet H. Hidden blood loss after surgery for hip frac- ture [J]. J Bone Joint Surg Br, 2006, 88(8) : 1053 -1059.
  • 9Erskine JG, Fraser C, Simpson R, et al. Blood loss with knee joint replacement [ J]. J R Coil Surg Edinb, 1981, 26 (5) : 295 - 297.
  • 10McManus KT, Velchik MG, Alavi A, et al. Non-invasive assess- ment of postoperative bleeding in TKA patients with Tc-99m RNCs [J]. J Nuclear Med, 1987, 28(8) : 565 -567.

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