高龄股骨粗隆间骨折手术治疗方法的疗效分析

目的研究空心钉加DHS、Gamma钉和PFNA3种不同内固定方法治疗高龄患者股骨粗隆间骨折的临床疗效。方法将150例高龄股骨粗隆间骨折患者分别按3种不同内固定方法治疗,随机分为空心钉加DHS54例,Gamma钉组51例,PFNA组45例。结果按Harris标准评定,PFNA和Gamma钉组的疗效优良率优于空心钉加DHS组;而PFNA组与Gamma钉组疗效优良率差异无统计学意义（P〉0.05）。在术中出血量、术后功能恢复、术后疼痛评分和内固定失效的比例数Gamma组和PFNA组均小于空心钉加DHS组（P〈0.05）。结论Gamma钉和PFNA内固定,它具有操作简单、固定牢固、手术损伤小、出血少、疗效优等优点,是治疗高龄股骨粗隆间骨折,尤其是不稳定型骨折的首选手术方式。

Clinical effective analysis of surgical methods on elderly intertrochanterie fracture

Objective To study the clinical efficacy in treatment of elderly patients with intertrochanteric fracture by the hollow nail plus DHS, or Gamma nail, or PFNA. Methods 150 cases of elderly patients with intertrochanteric fracture, according to three kinds of different fixation methods, were randomly divided into the hollow nail plus DHS group (54 cases), Gamma nail group (51 cases), and PFNA group (45 cases). Results According to Harris criteria scores, the rate of excellent and good effects in PFNA and Gamma nail groups are superior to that in hollow nail plus DHS group, the anterior postoperative functional recovery is also good; and the rate of excellent and good effects in PFNA group and Gamma nail group was no significant difference (P> 0.05). The bleeding volume, postoperation pain and failure ratio of internal fixation in Gamma nail and PFNA groups are less than that in hollow nail plus DHS group (P<0.05). Conclusion The methods of Gamma nail and PFNA fixation are simple, fixed firmly, less bleeding and excellent efficacy in treatment of elderly patients with intertrochanteric fracture, especially the unstable fracture of the intertrochanteric fracture.