治疗老年股骨粗隆间骨折三种内固定方法的评价

[目的]评价治疗老年股骨粗隆间骨折三种术式的疗效.[方法]174例老年股骨粗隆间骨折随机分为三组,分别采用DHS、PFNA、动力髋锁定系统(DHLS)内固定治疗.[结果](1)手术时间和术中出血量:PFNA组与DHS组及DHLS组与DHS组比较均具有统计学意义(P＜0.05),PFNA组和DHLS组比较无统计学差异(P＞0.05)；PFNA组与DHLS组用时和术中出血量均较DHS组少；(2)下地时间和完全负重时间:PVNA组与DHS组、DHLS组与PFNA组比较均具有统计学意义(P＜0.05),DHS组和DHLS组比较无统计学差异(P＞0.05)；PFNA组早于DHS组和DHLS组；(3)骨折愈合时间:PFNA组与DHS组及DHLS组与DHS组比较差异具有统计学意义(P＜0.05),PFNA组和DHLS组比较无统计学差异(P＞0.05).对于稳定性股骨粗隆间骨折的DHS组、PFNA组和DHLS组的优良率无显著差异,对于不稳定性股骨粗隆间骨折的PFNA组和DHLS组的优良率优于DHS组.[结论]对于老年股骨粗隆间骨折的治疗DHLS比DHS更为适合,但与PFNA对比各有所长.

Three kinds of internal fixation for intertrochanteric fracture in the elderly

[Objective]To study the clinical effect of three different kinds of internal fixation on intertrochanteric fracture in the elderly and to evaluate their merits and deficiencies.[Method]We retrospectively reviewed 174 patients treated for intertrochanteric fracture with DHS,PFNA and dynamic hip locking system(DHLS).The patients were divided into three groups: DHS group(50 cases),PFNA group(75 cases) and DHLS group(49 cases).The data of operative time,blood loss during operation,walking time,union time and hip function scores were recorded.[Result](1)The mean operative time and blood loss:there were significant differences between the PFNA,the DHLS and the DHS group.(2) The mean walking time and completely loading time,the PFN group A took the least time than the DHS and the DHLS groups.(3) Union time:there were significant differences between the PFNA,the DHLS and the DHS group.There were no significant difference in the excellent rate in the three groups in stable femoral intertrochanteric fractures.The excellent result rate of PFNA and DHLS groups were significantly higher than in DHS group in unstable femoral intertrochanteric fractures.[Conclusion]DHLS has more advantages to femoral intertrochanteric fractures in the elderly than DHS,but each of the PFNA and the DHLS groups has its good points.