股骨粗隆间骨折动力髋螺钉和防旋股骨近端髓内钉临床疗效比较

目的评价治疗股骨粗隆间骨折两种手术方式的疗效。方法回顾性分析动力髋螺钉（DHS）及防旋股骨近端髓内钉（PFNA）对98例股骨粗隆间骨折患者的治疗。统计骨折的分型，手术时间，术中术后出血量、术中输血量，术后疗效及并发症。结果（1）手术时间、术中出血量，术后引流量及术中输血量，两组间比较P〈0．05。PFNA组平均用时最短，术中出血及术后引流量最少；（2）术后并发症：两组间并发症发生率（P〈0．05），并发症总发生率DHS组最高；（3）疗效比较：DHS组、PFNA组优良率分别为82．4％、90．2％，组间差异无统计学意义（P〉0．05）。结论PFNA治疗股骨粗隆间骨折，以其术时短、损伤小、并发症发生率低及固定牢靠，在高龄不稳定粗隆间骨折应用中占有一定优势。

Comparison of dynamic hip screw fixation and proximal femoral nail anti-rotation in the treatment of femoral intertrochanteric fracture

Objective To evaluate the clinical efficacy of dynamic hip screw（DHS） fixation and proximal femoral nail anti -rotation（PFNA） in the treatment of intertrochanteric fracture （ITF）. Methods Clinical data of 98 patients with ITF who underwent DHS fixation or PFNA（ n = 49 in each group）were retrospectively analyzed. The fracture classification, operative time, bleeding volume, blood transfusion, operation complications and therapeutic efficacy were compared between the two groups. Results The PFNA group had shorter operation time and less bleeding than ITF group（ P 〈 0. 05 ）. The complication rate in the DHS group was higher than in the PFNA group. The excellent and good rate in the DHS group and the PF- NA group was 82.4% and 90.2% respectively with no statistical difference（ P 〉 0.05 ）. Conclusion The PFNA could be a reasonable choice for the treatment of intertrochanteric fractureunstable in the elderly patients with the advantages of less operative time and blood loss, lower postoperative complications and more stable fixation.