折疗效分析DHS与PFNA治疗粗隆间骨

目的比较动力髋螺钉(Dynamic hip screw,DHS)与防旋股骨近端髓内钉(Proximal femoral nail antirotation,PFNA)治疗股骨粗隆间骨折的临床疗效及优缺点。方法选取2009年2月~2012年4月在我院接受手术治疗的股骨粗隆间骨折患者92例,其中52例患者采用DHS进行治疗,其余40例患者采用PFNA进行治疗,前者为DHS组,后者为PHNA组。分别以切口长度、手术时间、术中出血量、并发症及平均住院时间作为临床评价指标系统评价两种手术方式的临床疗效,并通过Harris评分系统评价术后髋关节功能恢复情况。结果 PFNA组患者在切口长度、手术时间、术中出血量、并发症及平均住院时间均少于DHS组(<0.05)。术后髋关节恢复情况DHS组优良率为51.9%,PFNA组优良率为92.5%,PFNA组优良率显著高于DHS组(2=17.58,<0.05)。两组患者术后均得到随访,PFNA组长期随访髋关节功能改善优良率为100%,DHS组为63.5%(2=10.61,<0.05)。结论 PFNA在股骨粗隆间骨折治疗方面优于DHS。

Comparison of curative effect between DHS and PFNA in treatment of intertrochanteric femur fracture

Objective To compare the curative effect between dynamic hip screw（DHS） and proximal femoral nail antirotation（PFNA） in the treatment of intertrochanteric femur fracture and their Strengths and Weakness.Methods there are 92 cases in our hospital accepted the surgery treatment of intertrochanteric fracture from February 2009 to April 2012,of which 52 patients used DHS treatment,and rest of the patients took PFNA treatment,the former was DHS group and the latter was PHNA group.Using incision length,operation time,amount of bleeding,intraoperative complications and mean length of hospital stay as standards for the clinical system evaluation of two kinds of operation.Besides,we evaluated postoperative hip function using the Harris rating system.Result The incision length,operation time,amount of bleeding,complications and the mean length of hospital stay in PFNA group are less than DHS group（ 0.05）.In DHS group,the good rate of postoperative hip recovery is 51.9%,and in PFNA group is 92.5%,PFNA shows a better efficacy（2=17.58, 0.05）.Conclusion PFNA shows better curative effect in the intertrochanteric fracture treatment than DHS.