摘要
目的评价动力髋螺钉(DHS)与股骨近端髓内钉(PFN)治疗70岁以上的股骨粗隆间骨折患者的临床疗效。方法 2006年1月—2008年1月由第二军医大学附属长海医院骨科收治的96例股骨粗隆间骨折的患者,随机纳入DHS组和PFN组。根据AO分型系统进行骨折分型,评价两组手术失血总量(以红细胞压积所代表的百分数变化表示)、手术时间、切口长度、平均住院时间及术后并发症情况。结果 DHS组、PFN组临床疗效的优良率分别为81.2%、85.4%,差异无统计学意义(P>0.05)。DHS组切开长度显著大于PFN组(t=7.9,P<0.05)。两组间手术失血总量、手术时间、平均住院日、术后并发症发生率的差异均无统计学意义(P值均>0.05);但与DHS组比较,PFN组的手术时间、失血总量有减少的趋势。结论随着DHS技术的成熟,DHS与PFN治疗老年股骨粗隆间骨折的疗效的差异无统计学意义。但与DHS比较,PFN的手术时间、手术失血量相对较少,切口长度显著缩短,可作为治疗高龄骨质疏松性股骨粗隆间骨折优先考虑的疗法。
Objective To evaluate the short-term outcome of dynamic hip screw（DHS） and proximal nail （PFN）in the treatment of intertrochanteric fractures due to trauma in patients aged over 70 years old.Methods A total of 96 patients with intertrochanteric fractures were randomly divided into DHS group and PFN group during Jan.2006 to Jan.2008.The fractures were divided according to AO Classification.The intra-operative blood loss,operation time,length of incision,average hospital stay,and post-operation complications were analyzed. Results The excellent and good rates of patient outcomes in DHS group and the PFN group were 81.2%and 85.4%,respectively（P0.05）;the incision length of DHS group was significantly longer than that of PFN group （P0.05）.The blood loss,operation time,average length of hospital stay,and postoperative complications were all similar between the two groups（all P0.05）,although the operation time and blood loss had a decreasing tendency in PFN group.Conclusion With the maturation of DHS technique,DHS and PFN have similar efficacies in treatment of intertrochanteric fractures in elderly patients,but PFN has a shorter operation time,less blood loss,and shorter incision length,and should be the first choice for the elderly osteoporotic intertrochanteric fracture patients.
出处
《上海医学》
CAS
CSCD
北大核心
2010年第11期1039-1042,I0002,共5页
Shanghai Medical Journal
基金
上海市人事局人才发展基金资助项目(2009003)
中国博士后科研基金面上资助项目(20100470756)
