股骨近端防旋髓内钉与动力髋钉治疗股骨转子间骨折的临床研究
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[摘要] 目的 探讨股骨近端防旋髓内钉与动力髋钉治疗股骨转子间骨折的临床效果，为临床选择合适的治疗方案提供参考。 方法 采用回顾性分析的方法选择本院收治的临床确诊为股骨转子间骨折的患者60例的资料，其中研究组30例采用股骨近端防旋髓内钉（PFNA）治疗，对照组30例采用动力髋螺钉（DHS）治疗，记录两组手术时间、术中出血量、切口长度、骨折愈合时间，并采用Sadowski标准评价两组治疗效果，并进行组间比较。 结果 与对照组比较，研究组手术时间短，切口小，术中出血量少，骨折愈合时间短，组间比较差异有统计学意义（P < 0.05或P < 0.01）；两组疗效比较，研究组优良率为90%，对照组优良率为68%，两组比较差异有统计学意义（P < 0.05）。并发症比较，研究组并发症发生率为6%，对照组并发症发生率为20%，两组比较差异有统计学意义（P < 0.05）。 结论 股骨近端防旋髓内钉治疗股骨转子间骨折，效果优良，切口小，并发症少，骨折愈合快，值得推广。
[关键词] 股骨近端防旋髓内钉；动力髋螺钉；股骨转子间骨折；骨折愈合
[中图分类号] R683.42 [文献标识码] A [文章编号] 1673-7210（2012）08（c）-0050-03
Clinical research of proximal femur anti-spin intramedullary nail and dynamic hip screw in treatment of femoral intertrochanteric fractures
WU Jianguo TAN Shengfu
Department of Orthopaedic, the People's Hospital of Yishui County, Shandong Province, Yishui 276400, China
[Abstract] Objective To investigate the clinical effect of the proximal femoral intramedullary nail anti- rotation (PFNA) and dynamic hip nail (DHS) in the treatment of intertrochanteric fractures, and provide a reference for the clinical selection of appropriate treatment options. Methods The data of 60 cases of intertrochanteric fractures patients was selected and analyzed retrospectively, 30 cases of study group were given proximal femoral intramedullary nail (PFNA) treatment, 30 cases of control group were given dynamic hip screw (DHS) treatment；the operative time, blood loss, incision length, fracture healing time, and effect evaluated by Sadowski standards were compared between two groups. Results Compared with control group, the operative time of study group was shorter, incision was smaller, blood loss was less, fracture healing time was shorter, the difference between groups was statistically significant (P < 0.05 or P < 0.01); the excellent and good rate of the study group was 90%, and it was 68% in control group, the difference was statistically significant (P < 0.05); complication rate of study group was 6%, and that of the control group was 20%, the difference was statistically significant (P < 0.05). Conclusion The effect of PFNA in treatment of femoral intertrochanteric fractures is good, with small incision, less complications, quickly fracture healing, so it is worth promoting.
[Key words] Proximal femur anti- spin intramedullary nail; Dynamic hip screw; Intertrochanteric fractures; Fracture healing
股骨转子间骨折系指股骨颈基底至小转子水平以上部位所发生的骨折，是老年人常见的损伤。由于转子部血液循环丰富，骨折后愈合情况较好。但愈合良好的前提是早期进行手术治疗，早期复位、纠正髋内翻畸形、恢复股骨距、加强固定对提高生活质量，减少并发症有重要意义[1]。目前临床手术方法较多，主要有髋关节置换、动力髋螺钉（DHS），股骨近端防旋螺钉（PFNA）等。本文笔者比较后两者在治疗股骨转子间骨折中的应用效果，报道如下：