DHS与PFNA治疗股骨粗隆间骨折的临床价值比较

目的比较动力髋螺钉(Dynamic hip screw,DHS)与股骨近端防旋髓内钉(Proximal femoral nail antirotation,PFNA)治疗股骨粗隆间骨折的临床价值。方法选取2016年1月～2018年9月我院收治的股骨粗隆间骨折患者60例作为研究对象,按照随机数字表法分为观察组和对照组,每组30例。观察组行PFNA术,对照组行DHS术,对所有患者随访10个月,比较两组手术前后骨密度、机体骨降钙素水平、髋关节Harris功能评分及术后恢复情况。结果术后6个月,观察组骨密度和骨降钙素水平均高于对照组(P0.05);术后1个月,观察组髋关节Harris功能评分高于术前观察组及术后对照组(P0.05),观察组拄拐行走时间和弃拐独行时间均明显早于对照组(P0.05),术后骨折愈合时间早于对照组(P0.05)。结论采用PFNA治疗股骨粗隆间骨折能有效促进术后骨折愈合,确保术后髋关节功能。

Comparison of clinical value of DHS and PFNA in the treatment of intertrochanteric fractures

Objective To compare the clinical value of dynamic hip screw (DHS) and proximal femoral nail antirotation(PFNA) in the treatment of intertrochanteric fractures.Methods 60 patients with femoral intertrochanteric fractures admitted to our hospital from January 2016 to September 2018 were enrolled in the study.They were divided into observation group and control group according to the numerical random table method,with 30 cases in each group.The observation group underwent PFNA,and the control group underwent DHS.All patients were followed up for 10 months.The bone mineral density,body bone calcitonin level,the hip Harris function score before and after operation and the recovery after surgery were compared between two groups.Results At 6 months after operation,the bone mineral density and bone calcitonin level in the observation group were higher than those in the control group(P<0.05).At 1 month after operation,the hip Harris function score of the observation group was higher than that of the preoperative observation group and postoperative control group(P<0.05).The time of walking with crutches and walking without crutches of the observation group was significantly earlier than that of the control group(P<0.05),and the postoperative fracture healing time of the observation group was earlier than that of the control group(P<0.05).Conclusion Using PFNA to treat intertrochanteric fractures can effectively promote postoperative fracture healing and ensure postoperative hip joint function.