股骨粗隆间骨折三种内固定手术治疗效果分析

目的比较对股骨粗隆间骨折患者实施不同固定方式的治疗效果比较。方法对79例股骨粗隆间骨折分别采用股骨近端解剖钢板固定31例，动力髋螺钉（DHS）内固定27例，股骨近端髓内钉（PFN）内固定21例进行治疗，比较三组平均手术时间、骨折愈合时间和术后并发症，观察术后关节功能的恢复情况。结果三组的手术时间、骨折愈合时间、术后并发症和关节功能恢复情况无统计学差异。髋关节功能评分优良率：股骨近端解剖钢板组87％，DHS组92．6％，PFN组96％。术后随访时间平均为14个月，所有病例均骨性愈合。结论三种内固定方法各有其自身特点，都是治疗股骨粗隆间骨折的有效内固定方法，而股骨近端髓内钉固定是治疗粗隆间骨折最牢固的髓内固定方式，尤其适用于不稳定粗隆间粉碎性骨折。

Therapeutic effect of treatment of femoral trochanter fracture in 79 cases

Objective To discuss the therapeutic effect of plate fixation proximal femoral anatomy , dynamic hip screw plates （DHS） and PFN. Methods Seventy-nine femoral trochanter fracture patients were assigned to three groups. Thirty-one patients were treated with plate fixation of proximal femoral anatomy, twenty-seven patients were treated with DHS and twenty-one patients were treated with PFN. The average operation time, the fracture healing time, the postoperative complications and the hip function of the three groups were compared. Results There was no significant difference in the average operation time, the fracture healing time, the postoperative complications and the joint function recovery of three groups. The excellent and good rate of the hip joint function was as follows： the group of plate fixation proximal femoral fem proximal anatomy was 87%, the group of DHS was 92.6%, and the group of PFN was 96%. The mean followup time was fourteen months. All of the cases were healed. Conclusion Different fixation has its own feature, PFN is the best way of marrow internal fixation in curing inter-trochanter fracture, especially for unstable inter-trochanter comminuted fracture.