摘要
目的评价治疗股骨粗隆间骨折(ITF)三种术式的疗效。方法选择高龄患者71例,分为三组,即动力髋螺钉(DHS)组(26例)、股骨近端髓内钉(PFN)组(23例)、防旋股骨近端髓内钉(PFNA)组(22例),三组患者平均年龄分别为74.4、75.1、78.5岁。对手术时间、术中出血量、术后出血量、手术切口长度等进行比较,结果采取LSD检验,进行两组间的分别对比。同时分析比较三种不同内固定方法的优缺点。结果(1)手术时间:三组间比较(P<0.05);PFNA组用时最短,PFN组次之,DHS组用时最长。(2)术中出血量:PFNA组与DHS组(P<0.05);PFNA组术中出血量较少。(3)术后出血量:PFNA组与DHS组(P<0.05);PFNA组出血量较少。另外DHS组和PFN组有切割现象、髋内翻、骨折延迟愈合等并发症,PFNA未发现上述并发症。结论PFNA在三种手术方式中由于创伤小,出血少,手术时间短,固定坚强,无切割现象等特点,适合于高龄患者中多种类型的粗隆间骨折。
Objective To summarize the experience of three different kinds of internal fixation, dynamic hip screw （DHS）, proximal femoral nail （PFN） and proximal femoral nail anti-rotation （PFNA）, for intertrochanteric fracture （ITF） in the elderly and to evaluate their merits and deficiencies. Methods We retrospectively reviewed 71 patients who were treated for intertrochanteric fracture with DHS,PFN and PFNA from Mar. 2004 to Sept. 2007. The patients were divided into three groups： DHS group（26 cases） ,PFN group（23 cases） and PFNA group（22 cases）. The clinical parameters involved the mean operative time, the mean blood loss during operation and postoperation, incision length, etc. The LSD test was used. The other results which taken placed in operation or postoperative followed up were also analyzed. Results （1） The mean operative time： the PFNA group took the least time than the PFN and the DHS groups. （2） The mean blood loss during operation and postoperation： blood loss of the PFNA group was less than that in the DHS group. （3） Incision length： the mean lesion of the PFNA group was the least in three groups. Conclusion The PFNA is better for different fracture types and for elderly patients with ITF because of less operative time, less blood losts and tess incision length, which show that the PFNA may be a faster and safe surgical methed for interrochanteric fracture in the elderly.
出处
《中华老年多器官疾病杂志》
2009年第3期230-234,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
髋骨折
老年人
骨螺钉
intertroehanteric fracture
elderly
bone screws
