三种不同内植物固定治疗老年股骨转子间骨折

背景：治疗高龄患者股骨转子间骨折的内植物有传统的动力髋螺钉、防旋型股骨近端髓内钉、股骨近端解剖型锁定钢板,然而目前哪种内植物治疗方法较好仍存在争议。目的：分析动力髋螺钉、防旋型股骨近端髓内钉、股骨近端解剖型锁定钢板3种内植物治疗老年股骨转子间骨折的临床疗效。方法：回顾性分析159例老年股骨转子间骨折患者的临床资料,比较动力髋螺钉、防旋型股骨近端髓内钉、股骨近端解剖型锁定钢板治疗转子间骨折的差别。结果与结论：①置入后1周、6个月、1年髋关节功能Harris评分：防旋型股骨近端髓内钉组优于股骨近端解剖型锁定钢板组(P < 0.05),股骨近端解剖型锁定钢板组优于动力髋螺钉组(P < 0.05)。②置入后3,6,12个月X射线片显示骨折愈合情况：防旋型股骨近端髓内钉组优于股骨近端解剖型锁定钢板组(P < 0.05),股骨近端解剖型锁定钢板优于动力髋螺钉组(P < 0.05)。提示防旋型股骨近端髓内钉置入治疗老年转子间骨折具有创伤小、固定牢靠、操作简单、骨折愈合率高、愈合时间短、术后髋关节功能恢复好等优点,对于老年股骨转子间骨折患者应优先选择。

Three different kinds of implant fixators for intertrochanteric fractures in old people

BACKGROUND:Traditional dynamic hip screw (DHS), proximal femur nail anti-rotation (PFNA) and anatomic proximal femoral locking plate (APFLP) are used in internal fixation of intertrochanteric fractures, but now which one is best method for the treatment of intertrochanteric fractures is still controversial.OBJECTIVE:To investigate the clinical efficacy of the DHS, PFNA and APFLP for the treatment of the intertrochanteric fractures in old people.METHODS:Totally 159 elderly patients with intertrochanteric fractures were retrospectively analyzed. Difference of the DHS, PFNA and APFLP for the treatment of the intertrochanteric fractures was compared.RESULTS AND CONCLUSION:①Harris hip function score in the PFNA group was better than that in the APFLP group (P < 0.05) which was superior to DHS group (P < 0.05) at 1 week, 6 months and 1 year after surgery. ② X-ray of fracture healing in the PFNA group was better than that in the APFLP group (P < 0.05) which was superior to the DHS group (P < 0.05) at 3, 6, 12 months after surgery. It is indicated that the PFNA for the treatment of intertrochanteric fractures has many advantages in less damage, stronger fixation, simpler operation, higher fracture healing, shorter healing time, better functional recovery and so on. It is the ideal fixation for intertrochanteric fractures in old people.