3种不同方法治疗老年人股骨转子间骨折的临床观察

【摘要】〓目的〓探讨动力髋螺钉(DHS)、股骨近端髓内钉(PFNA)及人工股骨头置换术(FHR)治疗股骨转子间骨折的疗效。方法〓自2008年3月至2013年1月,收治58例老年股骨转子间骨折患者。分为3组:DHS组25例;PFNA组11例;FHR组22例。观察三组患者手术时间、术中出血量、功能锻炼时间及Harris髋关节功能评分等指标。结果〓术后随访8~18个月。手术出血最少为PFNA组,手术时间、锻炼时间,PFNA组和FHR组较DHS组有明显优势,差距均具有统计学意义(P<0.05)。Harris评分在DHS、PFNA、FHR三组的优良率分别64.0%、81.8%和86.4%,后2组均好于DHS组,但无统计学意义。结论〓PFNA组和FHR组治疗老年股骨转子间骨折,均可获得满意的临床效果。而PFNA组较FHR组更有出血少,手术创伤小的优势。

Clinical observation of three approaches for treatment of femoral intertrochanteric fractures in senile patients

Objective To evaluate the curative effect of dynamic hip screw （DHS）, proximal femoral nail antirotation （PFNA） and femoral head replacement （FHR） in the treatment of senile patients with intertrochanteric fractures. Methods Fifty-eight senile patient with intertrochanteric fractures in our hospital from March 2008 to January 2013 were divided into three groups： DHS group （n=25, treated with DHS）, PFNA group （n=11, treated with PFNA）, FHR （n=22. treated with FHR）. The operation time,mean intraoperative blood loss,function exercise time and the Harris hip function scores were observed. Results In follow-up period of 8-18 months,mean intraoperative blood loss of PFNA group was less than any other groups. The operation time,functional exercise time, the Harris hip function scores of PFNA group and FHR group was superior to the DHS group （P〈O.05）. Conclusion Both PFNA and FHR have good clinic efficacy in the treatment of intertrochanteric fractures. Compared FHR with PFNA which have advantage of less mean intraoperative blood loss and lower trauma.