股骨近端交锁髓内钉和股骨近端锁定解剖钢板治疗老年股骨粗隆间骨折的疗效比较

目的:比较股骨近端交锁髓内钉(PFN)和股骨近端锁定解剖钢板(DHS)治疗老年股骨粗隆间骨折的疗效。方法:回顾性研究本院2007年1月²011年7月收治的60岁以上的股骨粗隆间骨折手术患者共80例,行DHS治疗患者42例,PFN治疗患者38例,最少随访12个月。比较两组手术时间、出血量、复位质量、短期和长期手术并发症。在末次随访时评价患者髋关节功能情况。结果:PFN组患者的手术时间、出血量均优于DHS组的患者,但两组患者的输血量、手术并发症以及末次随访的Harris功能评分及优良率,两组均无显著性差异。两组均没有出现死亡及再手术的情况。结论:PFN和DHS治疗老年股骨粗隆间骨折均能取得较好的疗效,但PFN相对创伤较小,应优先考虑。

Comparison of the Curative Effects of the Proximal Femoral Nail Fixation and Dynamic Hip Screw in the Treatment of Unstable Intertrochanteric Fractures in Elderly Patients

Objective： To compare the effect of the proximal femoral nail fixation （PFN） and dynamic hip screw （DHS） in the treatment of unstable intertrochanteric fractures in elderly patients. Methods： This retrospective study comprised 80 patients with unstable intertrochanteric fractures were treated with either PFN （n=38） or DHS （n=40） for a minimum of 12 months follow up from January 2007 to July 2011. The data of demographic information, the operative time, blood loss, blood transfusions, complications, hospital stay, mortality and reoperation rate were collected. At the final follow-up, hip function was accessed with Harris hip score. Results： While the differences in operation time, blood loss, Harris hip scores between the two groups were of statistical significance, PFN group was superior to DHS group. No difference was found in the blood transfusions, complications and hospital stay between the two groups. Conclusions： Both PFN and DHS are safe and reliable devices for the treatment of unstable intertrochanteric fractures, while the trauma in PFN group is less than those in DHS group. The treatment of unstable intertrochanteric fractures in elderly patients should give priority to PFN.