摘要
目的比较老年骨质疏松性股骨转子间骨折患者采用不同内固定治疗的疗效。方法将85例老年骨质疏松性股骨转子间骨折患者按内固定治疗方法的不同分为3组,分别采用滑动加压动力髋螺钉(DHS组,40例)、股骨近端防旋髓内钉(PFNA组,30例)、股骨近端锁定板(锁定钢板组,15例)治疗,比较手术时间、术中出血量、骨折愈合时间、髋关节功能优良率、并发症发生率。结果患者均获得随访,时间6~18个月。3组患者手术时间、术中出血量以及骨折愈合时间比较差异均有统计学意义(P<0.05);手术时间和术中出血量PFNA组<锁定钢板组<DHS组,组间两两比较差异均有统计学意义(P<0.05);PFNA组骨折愈合时间明显短于锁定钢板组和DHS组(P<0.05)。术后6个月,髋关节功能恢复优良率PFNA组明显高于DHS组(P<0.05);并发症发生率PFNA组明显低于DHS组(P<0.05)。结论PFNA内固定治疗老年骨质疏松性股骨转子间骨折具有操作简便、出血量少、骨折愈合快、术后并发症少等优点,相比于DHS及股骨近端锁定板具有更高的临床应用价值。
Objective To compare the clinical efficacy of different internal fixation methods in the treatment of elderly patients with osteoporotic intertrochanteric fractures.Methods Eighty-five elderly patients with osteoporotic intertrochanteric fractures were divided into three groups,according to the internal fixation methods.Sliding compression dynamic hip screw(DHS group,40 cases),proximal femoral anti-rotation intramedullary nail(PFNA group,30 cases),and proximal femoral locking plate(locking plate group,15 cases)were performed respectively.The operation time,intraoperative blood loss,fracture healing time,excellent-good rate of hip function recovery and complication incidence rate were compared.Results All patients were followed up for 6~18 months.There were statistical differences in the operation time,intraoperative blood loss and fracture healing time among three groups(P<0.05).The operation time and intraoperative blood loss were PFNA group<locking plate group<DHS group,pairwise comparisons between two groups were statistically significant(P<0.05).The fracture healing time of PFNA group was significantly shorter than that of locking plate group and DHS group(P<0.05).At 6 months after operation,the excellent-good rate of hip function recovery in the PFNA group was significantly higher than that in the DHS group(P<0.05);the complication incidence rate in the PFNA group was significantly lower than that in the DHS group(P<0.05).Conclusions PFNA internal fixation for the treatment of elderly patients with osteoporotic intertrochanteric fractures has the advantages of simple operation,less bleeding volume,quick fracture healing,and fewer postoperative complications;which has higher clinical value,compared with the DHS and proximal femoral locking plate.
作者
徐杨俊
郑卫平
刘又生
路晓
XU Yang-jun;ZHENG Wei-ping;LIU You-sheng;LU Xiao(Dept of Orthopaedics, the Affiliated Dongtai Hospital of Nantong University, Yancheng, Jiangsu 224000,China)
出处
《临床骨科杂志》
2019年第6期727-730,共4页
Journal of Clinical Orthopaedics
关键词
股骨转子间骨折
骨质疏松
老年人
内固定
intertrochanteric fracture
osteoporosis
aged
internal fixation
