85例股骨转子间骨折内固定疗效分析

目的评估股骨转子间骨折不同内固定方法的疗效。方法回顾性分析大连市第四人民医院手术治疗的85例股骨转子间骨折患者临床资料,其中应用DHS内固定治疗44例,PFN内固定治疗26例,PFNA内固定治疗15例。结果所有患者均获得随访,随访时间8～36个月,平均22个月。应用Harris髋关节功能评分对疗效进行评定,DHS组对于Ⅰ、Ⅱ型骨折治疗优良率96.9%,Ⅲ、Ⅳ、Ⅴ型骨折治疗优良率为75%;PFN组对于Ⅲ、Ⅳ、Ⅴ型骨折治疗优良率95.8%;PFNA组治疗的优良率为100%。各组总优良率94.1%。结论对于股骨转子间骨折患者尤其是老年患者,如果全身情况允许,应该首先考虑手术内固定治疗,对于稳定型和EvansⅠ、Ⅱ型骨折,可以选用DHS固定;Ⅲ、Ⅳ、Ⅴ型骨折患者,更应选择PFN和PFNA进行固定。如果选择内固定材料得当,采用内固定治疗股骨转子间骨折能够取得满意的疗效。

Effect of Internal Fixation in 85 Cases of Femoral Intertrochanteric Fracture

Objective To evaluate the clinical effect of internal fixation in treatment of calcaneal intra-articular fracture.Methods The clinical data of 85 cases with femoral intertrochanteric fractures were analyzed retrospectively.All patients received the surgical treatment,44 cases with DHS,26 cases with PFN,and 15 cases with PFNA.Results All the patients were followed up for 8 to 36 months（average 22 months）.Under Harris clinical rating systems of hip,the rates of excellent and good results for type Ⅰ and Ⅱ were 96.9% in DHS group,75% for type Ⅲ,Ⅳ and Ⅴ.The rates of excellent and good results for type Ⅲ,Ⅳ and Ⅴ in PFN group were 95.8%,100% in PFNA group.The total rates of excellent and good results were 94.1% among all these groups.Conclusion For femoral intertrochanteric fractures,especially in the old patients,surgical treatment（internal fixation） should be performed.For stable fractures and type Ⅰ and Ⅱ of Evans classification,DHS is preferred;for type Ⅲ,Ⅳ and Ⅴ,PFN and PFNA are preferred.By selecting the surgery sign rightly,the satisfied effect could be obtained with internal fixation.