股骨近端髓内钉与动力髋螺钉系统治疗老年不稳定股骨粗隆间骨折60例疗效分析

目的：探讨和比较股骨近端髓内钉与动力髋螺钉系统治疗股骨粗隆间不稳定骨折的老年患者的临床疗效。方法：选取我院2009年-2012年的60例老年股骨骨折患者，随机分为对照组和实验组。对照组30例，采用股骨近端髓内钉治疗，实验组30例，采用动力髋螺钉系统治疗。结果：对照组切口长度9．1em±2．2cm，出血量265．8ml±1．1ml，手术时间90．5min±25．3min。实验组切口长度16．4cm±4．2cm，出血量405．3ml±67．6ml，手术时间124．5min±32．7min。对照组切口长度、出血量、手术时间均小于实验组，差异显著（P〈0．05）。对照组优25例，良2例，中2例，差1例，优良率90．00％。实验组优16例，良4例，中6例，差4例，优良率66．67％。对照组优良率大于实验组，差异显著（P〈0．05）。结论：采用股骨近端髓内钉与动力髋螺钉系统治疗老年股骨粗隆间不稳定骨折都有较好疗效，但是股骨近端髓内钉疗效更好，手术损伤小，在l临床上具有推广意义。

Proximal femoral nail and dynamic hip screw system the treatment of elderly patients with unstable intertrochanteric fractures of 60 Cases

Objective： To investigate and compare the eectiveness of the proximal femoral nail antirotation （PFN） and dynamic hip screw （DHS） in the treatment of elderly patients with intertrochanteric fractures. Methods： During 2009 to 2012, 60 elderly ca- ses were randomly selected and divided into two groups. Control group included 30 cases used PFN and test group included 30 cases used DHS. Results： The incision length, blood loss and operation time of control group is9. 1 ± 2. 2em, 265.8 ± 1.1 ml, 90. 5 ±25.3min. Test group isl6. 4 ±4. 2cm, 405.3±67. 6m1124. 5 ±32.7min. The incision length, blood loss and operation time of control group were less than test group （ P 〈 0. 05 ） . Harris hip score of control group is hihger than test group. The difference between Harris hip scores of two groups was statistically significant （P 〈 0.05 ） . Conclusion： Proximal femoral nail antirotation can have a better clinical effect than dynamic hip screw in the treatment of elderly patients with intertrochanterie fractures and can be popularized.