DHS和PFNA治疗老年股骨粗隆间骨折临床疗效对比

目的 比较动力髋螺钉（DHS）和股骨近端抗旋髓内钉（PFNA）治疗老年股骨粗隆间骨折的临床疗效。方法 选择2008年1月至2012年12月收治的老年股骨粗隆间骨折患者82例，按手术方式不同分为DHS组和PFNA组各41例，对两组患者的手术时间、术中出血量、骨折临床愈合时间、术后并发症和Harris髋关节功能评分进行分析比较。结果 PFNA组患者手术时间、骨折临床愈合时间短于DHS组，且术中出血量及术后并发症少于DHS组，差异均有统计学意义（P〈0.05）；PFNA组患者术后半年Harris髋关节评分优良率[95.1%（39/41）]高于DHS组[80.5%（33/41）]，差异有统计学意义（P〈0．05）。结论 PFNA治疗老年股骨粗隆间骨折具有手术时间短、术中出血少、骨折愈合快、术后并发症少等优点，其临床疗效优于DHS，特别适用于合并骨质疏松的老年股骨粗隆间骨折，是其理想的治疗方法 。

The Comparison on clinical efficacy of DHS and PFNA in the treatment of elderly patients with intertrochanteric fracture

Objective To compare the clinical efficacy of the dynamic hip screw （DHS） and proximal femoral nail an tirotation（PFNA） in the treatment of elderly patients with intertrochanteric fracture. Methods Selected 82 elderly patients with intertrochanteric fracture received from January 2008 to December 2012 in this hospital ,who were divided into the DHS group and the PFNA group according to different operation emthods,41 of each group. The operation time,the bleeding amount during the operation,the fracture healing time,the postoperative complications as well as the excellence rate of Harris hip joint function rating were analyzed compared between the two groups. Results The operation time,the bleeding amount during the operation, the fracture healing time,the postoperative complications of the PFNA group were less than those of the DHS group.The difference were statistically significant（P〈0.05）. The excellence rate of postoperative Harris hip joint function rating of the PFNA group after operation was 95.1%（39/41）,while that of the DHS group was 80.5%（33/41）. The difference was statistically sig-nificant（P〈0.05）. Conclusion PFNA has the advantages of shorter operation time,less bleeding amount during the operation, shorter fracture healing time and fewer postoperative complications,whose clinical efficacy was better than those of DHS. Obviously it′s a better treatment for the elderly with intertrochanteric fracture ,especially for those with unstable intertrochanteric fracture.