PFNA、DHS、LPFP治疗股骨粗隆间骨折的手术疗效

目的：探讨分析股骨近端防旋髓内钉(PFNA)、动力髋螺钉(DHS)、股骨近端锁定板(LPFP)3种手术内固定方法治疗股骨粗隆间骨折的效果。方法前瞻性整群选取该院骨科2013年9月—2015年5月期间收治的126例股骨粗隆间骨折患者作为研究对象,所选患者按随机数字法分为PFNA组、DHS组、LPFP组,每组各42例,对比3组患者应用不同手术方式的治疗效果。结果 PFNA组患者手术时间、下地负重时间、骨折愈合时间、总失血量少于LPFP组和DHS组(P=0.048、P=0.038、P=0.041、P=0.017)；PFNA组患者切口长度小于LPFP组和DHS组(P=0.020),PFNA组术后血色素下降小于其余两组(P=0.045)。 LCP组和DHS组比较,组间差异无统计学意义(P>0.05)。结论临床治疗股骨粗隆间骨折疾病可选用PFNA方式进行治疗,此方式属于微创手术,和人体生物力学相符,降低患者失血量,对患者预后有良好作用,临床有一定应用价值。

Operative Curative Effect of PFNA,DHS, LPFP in Treatment of Femoral Intertrochanteric Fracture

Objective To discuss and analyze the three operative internal fixation methods including proximal femoral nail anti-rotation, dynamic hip screw and femoral locking plates in treatment of femoral intertrochanteric fracture. Methods 126 cases of patients with femoral intertrochanteric fracture admitted and treated in the department of orthopaedics of our hospi-tal from September 2013 to May 2015 were prospectively included as the research objects and randomly divided into the PFNA group, DHS group and LPFP group with 42 cases in each, and the treatment effects of the different operative methods of the three groups were compared. Results The operative time, weight-bearing time, fracture healing time and total blood loss in the PFNA group were less than those in the LPFP group and the DHS group, (P=0.048, P=0.038, P=0.041, P=0.017);the cut length in the PFNA group was smaller than that in the LPFP group and the DHS group, (P=0.020), the postoperative hemochrome decrease in the PFNA group was less than the other two groups,(P=0.045), and the difference between the LCP group and the DHS group had no statistical significance by comparison (P>0.05). Conclusion The PFNA method can be se-lected in clinical treatment of femoral intertrochanteric fracture, and the method belongs to minimally invasive surgery and conforms to the physical ergonomics, which can decrease the blood loss of patients and has a good effect on the prognoses of patients, and it is of a certain application value in clinic.