动力髋螺钉和股骨近端抗旋转螺钉治疗股骨粗隆问骨折的临床效果观察

目的比较股骨近端抗旋转螺钉（PFNA）和动力髋螺钉（DHS）治疗股骨粗隆问骨折的治疗效果。方法对64例股骨粗隆问骨折患者，分别应用DHS及PFNA手术方法进行治疗，观察手术切口长度、手术时间、术中甲均出血量、平均愈合时间，手术并发症及髋关节功能评分等指标。结果PFNA组患者手术时间，切口长度，术后下地时间，住院天数均明显短于DHS组，手术中出血量也明显少于DHS组，差异均有统计学意义（P〈0．01）。PFNA组患者髋关节功能评定为优的比例明显高于DHS组，而评定为可的比例明显低于DHS组（P〈0．05），差异有统计学意义。PFNA组患者股骨干骨折和髋内翻各发生1例，DNS患者2例发生股骨=F骨折和1例发生髋内翻。结论PFNA治疗股骨粗隆间骨折较DNS具有操作简单，出血少，手术时间短，并发症少等特点，值得临床广泛推广。

Clinical observation on the effects of DHS and PFNA on intertrochanteric fracture of femur

Objective To study the clinical effect of dynamic hip screw and proximal femoral nail antirotation on in- tertroehanteric fractures patients. Methods A total of 64 patients with intertrochanteric fractures were treated randomly with PFNA or DHS internal fixation. Main outcome measurements included the incision length, the operation time, blood loss, average fracture healing time, complication,and functional outcome, etc. Results PFNA operation time in patients, hand blood loss,incision length,postoperative ambulation time and hospital stay were significantly less than the DHS group,the difference was statistical significance （P 〈 0. 01 ） PFNA hip function in patients rated as excellent was significantly higher than the DHS group, while the ratio of assessed to be significantly lower than the DHS group （ P 〈 0.05 ） , the difference was significant, PF- NA patients femoral shaft and hip fractures occurred in 1 case each in turfs, DNS 2 cases occurred Femoral shaft fracture and 1 case of varus. Conclusion PFNA can be recommended to treat intertrochanteric fractures because of satisfactory effect and high quality of life after the operation.