动力髋螺钉和股骨近端髓内钉治疗股骨转子间骨折和转子下骨折的临床观察

目的:比较采用动力髋螺钉和股骨近端髓内钉治疗股骨转子间骨折和转子下骨折的疗效及安全性。方法:将39例股骨转子间骨折和转子下骨折患者随机分为2组,分别采用动力髋螺钉内固定和股骨近端髓内钉内固定,比较两组患者的骨折愈合时间、髋关节功能及并发症。结果:随访12～24个月,平均17个月,骨折全部愈合。动力髋螺钉组骨折愈合时间比股骨近端髓内钉组长(t=3.086 0,P=0.004 1);两组髋关节功能的比较,差异无统计学意义(x2=3.298 3,P=0.069 4);动力髋螺钉组髋内翻的发生率高于股骨近端髓内钉组(P=0.048 9);两组股骨颈缩短的发生率,差异无统计学意义(P=0.050 2)。结论:与动力髋螺钉相比,采用股骨近端髓内钉内固定,骨折愈合时间短、并发症少,适用于股骨转子间骨折和转子下骨折。

Clinical observation on the curative effects of dynamic hip screw and proximal femoral nail in the treatment of intertrochanteric fracture and subtrochanteric fracture

Objective：To compare the curative effects and safety of dynamic hip screw（DHS）and proximal femoral nail（PFN）in the treatment of intertrochanteric fracture and subtrochanteric fracture.Methods：39 patients with intertrochanteric fracture or subtrochanteric fracture were randomly divided into 2 groups and were administrated with internal fixation by DHS and PFN respectively.The fracture healing time,hip joint function and complications of patients were compared between the 2 groups.Results：The follow-up ranged from 12 to 24 months with an average of 17 months,all fractures healed.The fracture healing time of patients in DHS group was longer than that of patients in PFN group（t=3.086 0,P=0.004 1）.There was no statistical difference in the hip joint function between the 2 groups（x2=3.298 3,P=0.069 4）.The incidence rate of coxa vara of DHS group was higher than that of PFN group（P=0.048 9）.There was no statistical difference in the incidence rate of femoral neck shortening between the 2 groups（P=0.050 2）.Conclusion：Compared with DHS,internal fixation with PFN has shorter fracture healing time and less complications for intertrochanteric fracture and subtrochanteric fracture.