股骨近端防旋髓内钉在老年股骨粗隆间骨折治疗中的应用

目的探讨应用股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折的临床疗效和意义。方法收集2005年6月至2010年6月诊治的年龄在65岁以上的老年股骨粗隆间骨折患者72例,分为对照组34例和治疗组38例,分别采用PFNA和动力髋螺钉(DHS)内固定治疗。结果治疗组的平均手术时间为90.0±12.0 min、平均术中出血量为180.0±15.0 ml、平均住院时间20.0±1.0 d、平均临床愈合时间11.9±1.5周。疗效判定优13例、良23例、差2例,优良率为94.74%,均明显优于对照组,两组比较差异有统计学意义(P<0.05)。结论对于老年股骨粗隆间骨折患者,根据骨折类型合理选择PFNA与DHS进行内固定治疗均可取得满意疗效,但应用PFNA治疗的手术时间、术中出血量、卧床时间和术后并发症等均方面优于DHS且临床疗效更加可靠。

PFNA in Treatment on the intertrochanteric fractures of elderly

Objective To study the clinical results of intertrochanteric fractures of the elderly using proximal femoral nail anti-rotation（PFNA）.Methods From June 2005 to June 2010,72 cases of intertrochanteric fractures of the elderly treated in our hospital were divided into two groups ： 34 cases in control group were treated with DHS,38 cases in treatment group with PFNA.Results In the treatment group,the average operation time was 90±12 min、the average blood loss was 180±15ml、the mean hospital duration was 20.0±1.0 d and the average healing time of bonefracture was 11.9±1.5 weeks.According to functional criteria,the results were excellent in 13 cases,good in 23,and fair in 2,the rate of excellent and good was 94.74%.The treatment group were obviously better than that of the control group（P0.05）.Conclusion The results are satisfactory when treated with PFNA or DHS for the patients of intertrochanteric fractures of the elderly.But the clinical effect of PFNA is better than that in DHS from the average operation time、blood loss、the mean hospital duration、the postoperative complications.