三种手术方法治疗老年性股骨颈及股骨粗隆间骨折的临床效果比较

目的:研究适合老年性股骨颈及股骨粗隆间骨折治疗和减少并发症发生的方法。方法:采用回顾性分析的方法，选取我院2019 年12 月—2021 年12 月收治的246 例老年股骨颈及股骨粗隆间骨折患者，按照骨折类型将其分成接受股骨颈动力交叉钉系统治疗组(FNS 组，24 例)、股骨近端防旋髓内钉治疗组(PFNA 组，49 例)及动力型加压髋螺钉组(DHS组，173 例)，比较三组临床治疗后的并发症发生率、手术时间、骨折愈合时间、术中出血量、生活质量评分及术后活动能力评分比较。结果:股骨颈动力交叉钉系统治疗组所造成的创伤比较小，手术时间、术中出血量、术后并发症发生率均显著低于股骨近端防旋髓内钉治疗组和动力型加压髋螺钉组(P <0.05)，而股骨近端防旋髓内钉治疗组与动力型加压髋螺钉组比较，差异无统计学意义(P >0.05)；股骨颈动力交叉钉系统治疗组的生活质量评分及活动能力评分高于其他两组(P <0.05)。结论:FNS 适用于一型和二型股骨颈骨折的患者，DHS 适用于大粗隆外侧皮质完整的患者，PFNA 适用于骨折累及粗隆、大粗隆下骨质的患者。

Comparison of Clinical Effects of Three Surgical Methods in the Treatment of Senile Femoral Neck and Intertrochanteric Fractures

Objective To analyze the treatment method of senile femoral neck and intertrochanteric fractures. Methods Using the retrospective analysis method, in the study of 246 elderly patients with femoral neck and intertrochanteric fractures admitted to our hospital from December 2019 to December 2021. Then according to the type of fracture, break it into hollow nail treated groups (FNS group, 24 patients), dynamic compression condyle screw treatment group (PFNA group, 49 patients) and dynamic compression hip screw group (DHS group, 173 patients), they compared the complication rate, operation time, fracture healing time, bleeding volume, quality of life and postoperative mobility score of the three groups. Results The operation time, intraoperative bleeding and postoperative complications of FNS group were lower than the other groups(P <0.05), The FNS group compared with the other two groups, elderly patients with senile femoral neck and femoral intertrochanteric fractures should complete the prediction of fracture operation risk according to their indications and choose the relevant surgical methods scientifically. Conclusion FNS is suitable for patients with type I and Type II femoral neck fractures, and DHS is suitable for patients with intact lateral greater trochanter cortex, PFNA is suitable for patients with fracture involving trochanteric and subtrochanteric bone.