动力髋螺钉和防旋股骨近端髓内钉治疗股骨粗隆间不稳定型骨折的效果对比

目的探讨动力髋螺钉（DHS）和防旋股骨近端髓内钉（PFNA）治疗股骨粗隆间不稳定型骨折的临床效果。方法选取2010年3月～2011年3月余姚市第四人民医院治疗的86例股骨粗隆间不稳定型骨折患者作为研究对象,根据手术方式不同分为PFNA组和DHS组,其中42例采用PFNA治疗,44例采用DHS固定治疗,对两组手术情况、治疗效果、术后并发症等进行对比观察。结果 86例患者经治疗后骨折均全部愈合,其中PFNA组髋关节功能评定优良率为95.23%（40/42）,明显优于DHS组的77.27%（34/44）,组间差异有统计学意义（P〈0.05）;PFNA组手术时间（49.8±16.1）min]、术中出血量（259.2±120.3）mL]、术后引流量（83.9±71.4）mL]、切口长度（8.6±1.7）cm]、骨折愈合时间（12.7±1.1）d]、活动时间（4.2±1.3）d]、并发症发生率（9.52%）均优于DHS组（85.1±17.6）min、（466.6±161.3）mL、（199.6±115.3）mL、（17.1±3.2）cm、（14.3±3.0）d、27.27%],组间差异均有统计学意义（均P〈0.05）。结论 PFNA治疗股骨粗隆间不稳定型骨折能够达到更好的治疗效果,值得临床推广和应用。

Effect comparison of proximal femoral nail antirotation and dynamic hip screw in treatment of unstable intertrochanteric fracture

Objective To investigate the effect of dynamic hip screw（DHS） and proximal femoral nail antirotation（PF NA） in treatment of unstable intertrochanteric fracture.Methods 86 cases of unstable intertrochanteric fracture patients from March 2010 to March 2011 in the People ’s Hospital of Yuyao City were selected as research subjects,all patients were divided into PFNA group and DHS group according to surgical approach,42 cases were given PFNA treatment,and 44 patients were given DHS fixation,the surgery situation,treatment effect and postoperative complica tions of two groups were compared.Results Fractures of 86 patients all healed after treatment,the excellent rate of hip function in PFNA group 95.24%（40/42）] was significantly better than the DHS group 77.27%（34/44）],the difference between two groups was statistically significant（P ＆lt; 0.05）;the operative time（30.9±16.1） min],blood loss （259.2± 120.3） mL],postoperative drainage （83.9 ±71.4） mL],incision length （8.6 ±1.7） cm],fracture healing time （12.7 ±1.1） d],exercise time （4.2 ±1.3） d],incidence of complications（9.52%） of PFNA group were all better than DHS group （85.1 ±17.6） min,（466.6 ±161.3） mL,（199.6 ±115.3） mL,（17.1 ±3.2） cm,（14.3 ±3.0） d,27.27%],the differences between the groups were statistically significant（P ＆lt; 0.05）.Conclusion PFNA treatment for unstable intertrochanteric fracture can achieve better therapeutic effect,it is worthy of clinical application.