骨近端髓内钉与动力髋螺钉治疗老年股骨粗隆间骨折临床疗效比较

目的  比较股骨近端髓内钉（PFNA）和动力髋螺钉（DHS）治疗老年股骨粗隆间骨折的疗效差别。方法  回顾性分析2012年9月-2014年7月在苏州市第七人民医院手术并获得随访的85例老年股骨粗隆间骨折患者，根据手术方式不同，将患者分为PFNA组45例，DHS组40例。比较两种术式的手术时间、手术中出血量、手术后引流量、手术后下地时间、骨折愈合时间、手术后并发症及髋关节Harris评分等指标。结果  所有患者均获得随访，随访7～14个月，平均8个月。PFNA组在手术时间、术中出血量、术后伤口引流、术后下地负重时间上优于DHS组（P <0.05）；术后患者均获随访，两组骨折愈合时间、早晚期并发症发生率、髋关节Harris评分比较差异无统计学意义（P >0.05）。结论  PFNA治疗老年股骨粗隆间骨折的疗效优于DHS，对高龄股骨粗隆间骨折应首选PFNA治疗。

PFNA and DHS in treatment of intertrochanteric fracture

Objective To compare the clinical effects of PFNA and DHS in the treatment of intertrochanteric fracture. Methods We retrospected 85 cases with femoral intertrochanteric fracture who were treated in our hospital from September 2009 to October 2013. Patients were classified into two groups according to the way of operation, 45 of 85 cases were done by PFNA, and 40 of 85 cases were done by DHS. The operative time, bleeding volume, wound drainage, walking time, fracture healing time, postoperative complications and hip function of each group were collected for statistical analysis. Results All patients were followed up for 8 months (7-14 months). The mean operative time, bleeding, wound drainage, walking time in PFNA group were significantly lower than the DHS group (P < 0.05). Walking time, fracture healing time, postoperative complications and hip function were similar in two groups (P > 0.05 ). Conclusions PFNA is more suitable for intertrochanteric fracture in elderly patients, especially for the intertrochanteric femoral fracture with serious osteoporosis.