股骨近端锁定钢板与动力髋螺钉治疗A2型股骨转子间骨折的效果比较

目的 探讨和比较股骨近端锁定钢板与动力髋螺钉治疗A2型股骨转子间骨折的效果.方法 回顾性分析2010年6月～2012年6月本科73例A2型股骨转子间骨折患者的临床资料,股骨近端锁定钢板组41例采用股骨近端锁定钢板治疗,动力髋螺钉组32例采用动力髋螺钉治疗,比较两组的手术时间、术中出血量、住院时间、术后并发症发生率及疗效.结果 两组手术时间和住院时间比较差异无统计学意义（P＞0.05）.两组术中出血量比较差异有统计学意义（P＜0.05）.两组术后并发症发生率比较差异无统计学意义（P＞0.05）.动力髋螺钉组和股骨近端锁定钢板组的优良率分别为87.5％ （28/32）、90.2％（37/41）,差异无统计学意义（P＞0.05）.结论 股骨近端锁定加压钢板和动力髋螺钉内固定都是治疗老年A2型股骨转子间骨折比较理想的治疗方法,尤其是股骨近端锁定钢板具有创伤小、骨膜不需剥离、术中出血少等优点.

Effect comparison of proximal femoral locking plate and dynamic hip screw in the treatment of A2-type intertrochanteric fracture

Objective To explore and compare the effect of proximal femoral locking plate and dynamic hip screw in the treatment of A2-type intertrochanteric fracture. Methods Clinical data of seventy-three patients with A2-type in- tertrochanteric fracture in our department from June 2010 to June 2012 were retrospectively analyzed.Proximal femoral locking plate treatment was used in proximal femoral locking plate group （41 cases）,dynamic hip screw treatment was applied in dynamic hip screw group （32 cases）.Operation time,intraoperative amount of bleeding,hospital stay,incidence rate of postoperative complication and the effect in two groups were compared. Results There were no statistical differ- ence in operation time and hospital stay between two groups （P〉0.05）.Intraoperative amount of bleeding in two groups was compared,with statistical difference （P〈0.05）.Incidence rate of postoperative complication in two groups was com- pared,with no statistical difference （P〉0.05）.The excellent and good rate of dynamic hip screw group and proximal femoral locking plate group was 87.5%（28/32）and 90.2%（37/41）respectively,with no statistical difference（P〉0.05）. Con- clusion Both proximal femoral locking plate and dynamic hip screw for internal fixation are ideal therapeutic methods in the treatment of elderly A2-type intertrochanteric fracture,especially the former one at advantages of small wound, non-stripping of periosteum and little bleeding during surgery,etc.