PFNA与DHS治疗老年股骨粗隆间骨折的疗效比较

目的 比较PFNA与DHS治疗老年股骨粗隆间骨折的疗效.方法 160例老年股骨粗隆间骨折患者随机分为PFNA组及DHS组各80例,比较两组患者的优良率、髋关节功能Harris评分、并发症.结果 PFNA组A22、A23、A3型的优良率达84.2％,与DHS组比较差异有统计学意义（P＜0.05）.PFNA组患者手术时间、骨折愈合时间明显短于DHS组,而手术出血量明显少于对照组（P＜0.05或P＜0.01）.两组患者术后髋关节功能Harris评分分别较术后1个月均明显升高,但PFNA组术后3个月、术后6个月、术后12个月的髋关节功能Harris评分分别与DHS组比较,差异无统计学意义（P＞0.05）.PFNA组的并发症发生率10.0％,明显少于DHS组（P＜0.05）.结论 PFNA与DHS均为治疗老年股骨粗隆间骨折的有效内固定方法之一,但PFNA内固定较DHS更具优势,其具有创伤小、手术时间短、术中出血少、术后并发症少等优点.

The effect comparison of PFNA and DHS in treatment of elderly intertrochanteric fractures

Objective To investigate the effect of PFNA compared with DHS in treatment of elderly intertrochanteric fractures. Methods A total of 160 tertrochanteric fractures patients were random divided into PFNA grSup and DHS group of 80 patients ,the effect,Harris hip score and complications were compared. Results PFNA group＇ A23, A3 type＇xcellent rate of 84.2%,was better than DHS group （P〈O.05）. The Harris hip scores of PFNA group after treatment 3,6,12 months were compared with the DHS group, the difference was not statistically significant （P〉O.05）.PFNA group complication rate of 10.0% ,was significantly less than DHS group （P〈O.05）. Conclusion PFNA and DHS are senile intertrochanteric fracture fixation methods effective,but PFNA fixation advantages over DHS,which has a trauma, shorter operative time, less blood loss, postoperative complications less, etc., should be popularized and applied.