DHS与PFNA治疗高龄股骨粗隆间骨折的疗效评价

目的比较高龄股骨粗隆间骨折的两种常用手术方法的治疗效果。方法选择笔者所在医院自2004年以来收治的年龄大于70周岁的高龄粗隆间骨折患者36例，分别应用DHS及PFNAⅡ手术方法进行治疗，观察手术切口长度、手术时间、术中平均出血量、平均愈合时间等指标。结果两组患者在手术内固定的过程中均没有并发症发生，术后拍摄X线片复查，骨折复位良好，固定牢固，随访6～36个月，36例骨折全部愈合，与DHS手术方法比较，PFNAlI组患者手术切口长度、平均手术时间、术中平均出血量明显减少，差异有统计学意义（P〈0．01）；两组平均骨折愈合时间比较，差异无统计学意义（P〉0．05）。结论与DHS组比较，PFNA在高龄股骨粗隆间骨折患者的治疗中，操作简单，手术切口小，术中出血少，手术时间短，固定牢固可靠，是目前治疗高龄股骨粗隆间骨折的首选手术方式。

Compare the Clinical Effect between DHS and PFNA on Intertrochanteric Fracture of Femur Occurred in Elderly Patients

Objective To compare the clinical effect between DHS and PFNA on intertrochanterie fracture of femur occurred in elderly patients.Methods 36 patients （ age 〉 70 years ） suffered from intertroehanterie fracture of femur were observed.20 cases were undergo DHS （ Dynamichip screw ） operation, meanwhile 16 eases were undergo PFNA Ⅱ （ Proximal femoral nail antirotation Ⅱ ） operation.Operating length, operating time, operating bleeding volume and recovery time were observed.Results No operating complication occurred in all cases, each case was healed.Compared to DHS group, the operating length, operating time, operating bleeding volume were decreased significantly in PFNA Ⅱ group, which had statistical differences （ P 〈0.01 ） .The recovery time was no difference between the two groups （P〉 0.05 ）.Conclusion Compared to DHS operating method, PFNA Ⅱ operating method has advantages the operating length, operating time, operating bleeding volume were decreased, which should be the first choose on the treatment of intertrochanteric fracture of femur in elderly patients.