DHS与InterTan内固定治疗老年股骨粗隆间骨折的疗效比较

目的比较采用动力髋螺钉(DHS)、InterTan系统内固定治疗老年股骨粗隆间骨折的疗效。方法回顾性分析自2009-01—2010-02采用DHS内固定治疗的47例老年股骨粗隆间骨折与自2010-03—2013-05采用InterTan内固定治疗的39例老年股骨粗隆间骨折。比较2组切口长度、手术时间、术中出血量、X线透视次数、住院时间、开始下地负重时间、骨折愈合时间,以及术后6、12个月髋关节功能Harris评分。结果 86例均获得6~24(16.35±3.15)个月随访。与DHS组相比,InterTan组切口长度较短、术中出血量较少、开始下地负重时间更早,但手术时间更长、X线透视次数更多,差异有统计学意义(P0.05)。InterTan组与DHS组住院时间及骨折愈合时间比较差异无统计学意义(P0.05)。InterTan组术后6、12个月的髋关节功能Harris评分优良率均明显高于DHS组,差异有统计学意义(P0.05)。结论 InterTan系统内固定治疗老年股骨粗隆间骨折具有创伤小、出血少、固定稳定、并发症少、术后功能恢复快等优点。

Comparison of DHS and InterTan internal fixation for treatment of femoral intertrochanteric fractures

Objective To compare the therapeutic effect between dynamic hip screw (DHS) and InterTan in the treatment of femoral intertrochanteric fractures.Methods The clinical data of 86 patients with femoral intertrochanteric fractures undergoing DHS internal fixation (47 cases) from January 2009 to February 2010 and TRIGEN InterTan fixation (39 cases) March 2010 to May 2013 were retrospectively reviewed.Length of incision,blood loss during operation,length of stay,operating time,fracture healing time,X-ray frequency,weight bearing time,and the Harris score of hip joint function in six months and twelve months after operation were compared.Results Eighty-six cases were all followed up for 6-24 months,with an average of (16.35±3.15)months.The operative time,surgical incision,blood loss during operation,X-ray frequency and weight bearing time were compared between two groups,the differences were statistically significant (P ＜0.05).And there were no statistical differences in the hospital stay time,fracture healing time between the two groups (P ＞0.05).The excellent and good rate of Harris score of hip joint function in InterTan group was significantly higher than that in DHS group at 6 and 12 months after operation,and the difference was statistically significant (P ＜0.05).Conclusion Compared with DHS,the InterTan internal fixation for the treatment of femoral intertrochanteric fractures in elderly patients has the advantages of less damage,less blood loss,stable fixation,less complications and faster postoperative recovery.