股骨近端解剖锁定钢板及动力髋螺钉治疗老年股骨转子间骨折的对比研究

[目的]比较治疗老年股骨转子间骨折的两种不同内固定方法的疗效.[方法]回顾性分析2006年1月～2010年10月收治的82例老年股骨转子间骨折患者,其中应用动力髋螺钉(DHS组)39例,股骨近端解剖锁定钢板(LCP组)43例,比较手术切口长度、手术时间、术中出血量、术后引流量、住院天数、骨折临床愈合时间、术后并发症.[结果]两组患者均获得随访,时间6 ～ 28个月,平均16.3个月,无切口感染及死亡病例.术后髋关节功能按Hamis评分,LCP组平均(92.5±1.8)分,DHS组(90.8±1.7)分,两组比较无差别(P＞0.05),两组的手术切口长度、住院天数、骨折临床愈合时间、术后并发症比较无差别(P＞0.05),LCP组手术时间较DHS组少(P＜0.05),术中出血量和术后引流量均低于DHS组(P＜0.05)[结论]使用股骨近端解剖锁定钢板及动力髋螺钉治疗老年股骨转子间骨折,临床疗效相仿,但应用股骨近端解剖锁定钢板治疗具有手术操作简单、创伤小和出血少等优点.

Comparative study of the treatment of intertrochanteric fractures of the aged patients with locking compression plate and dynamic hip screw

[Objective]To compare and investigate the clinical effects of two internal fixation treating methods on the treatment of intertrochanteric fracture of femur in elderly patient.[Method]Eighty-two cases of fresh intertrochanteric fracture of femur were reviewed retrospectively.All cases were divided into two groups: group A was treated with dynamic hip screw(DHS),group B was treated with LCP(locking compression plate).Perioperaive indices of patients were statistically analyzed,such as length of incision,operation time,blood loss,drainage,time in hospital,time of fracture clinical healing and postoperative complications so on.The mediumterm or longterm curative effect of each treatment was assessed.[Result]The 6-28 months follow-up were taken in 82 cases without death(16.3 months on the average).All cases had healed without delayed healing.According to Harris criterion,the joint function score in LCP group were 92.5±1.8 points on the average,DHS group were 90.8±1.7 points on the average,there were no significantly statistical differences in the joint function score and length of incision,time in hospital,time of fracture clinical healing and postoperative complications(P>0.05).There were significantly short operation time and less blood loss and less drainage in group LCP than that in DHS group(P<0.05).[Conclusion] We believe that the LCP and the DHS have the same clinical effect in treatment of intertrochanteric fracture of femur in elderly patient,but LCP might have advantages of less blood loss,mini-invasive,more simple operation.