PFNA与DHS内固定治疗股骨粗隆间骨折的效果比较

发布时间：2018-03-14 07:58

本文选题：股骨近端防旋髓内钉　切入点：动力髋螺钉　出处：《中国矫形外科杂志》2017年16期 　论文类型：期刊论文

【摘要】：[目的]比较股骨近端防旋髓内钉(PFNA)与动力髋螺钉(DHS)内固定治疗股骨粗隆间骨折的效果。[方法]随机数字法将70例股骨粗隆间骨折患者分为2组,每组35例。PFNA组给予PFNA治疗,DHS组给予DHS治疗。观察两组围术期指标(手术时间、术中出血量、下床负重时间、住院时间、骨折愈合时间)、术后并发症(股骨头坏死、骨折延迟愈合、内固定切出、钢板断裂)、髋关节Harris评分及临床疗效。[结果]PFNA组手术时间、术中出血量、下床负重时间、住院时间及骨折愈合时间明显低于DHS组(P0.05)。PFNA组术后并发症率为2.82%,低于DHS组的11.42%,但差异无统计学意义(P0.05)。末次随访两组Harris评分各指标显著升高(P0.05),且PFNA组Harris评分各指标显著高于DHS组(P0.05)。末次随访PFNA组总优良率为91.43%,显著高于DHS组的71.43%(P0.05)。[结论]PFNA和DHS均可用于股骨粗隆间骨折的临床治疗,其中PFNA具有手术创伤小、并发症低、预后恢复好的优点。
[Abstract]:[objective] to compare the effect of the treatment of femoral intertrochanteric fractures with PFNA- and DHS- (dynamic hip screw) internal fixation. [methods] 70 patients with intertrochanteric fractures of femur were randomly divided into two groups. 35 patients in each group were treated with PFNA. The indexes of perioperative period (operation time, intraoperative blood loss, weight loading time, hospitalization time, fracture healing time and postoperative complications (necrosis of femoral head) were observed. Delayed union, internal fixation, plate fracture, hip joint Harris score and clinical effect. [results] in PFNA group, operative time, intraoperative blood loss, time to get out of bed, load time, The hospitalization time and fracture healing time were significantly lower than that of DHS group (P 0.05). PFNA group was lower than that of DHS group (2.82), but the difference was not statistically significant (P 0.05). At the last follow-up, the Harris scores of the two groups were significantly higher than that of the PFNA group (P 0.05), and the Harris scores of the PFNA group were significantly higher than those of the PFNA group. The total excellent and good rate in PFNA group was 91.43, which was significantly higher than that in DHS group. [conclusion] PFNA and DHS can be used in the treatment of intertrochanteric fracture of femur. Among them, PFNA has the advantages of less surgical trauma, lower complications and better prognosis.
【作者单位】：中国贵航集团三O二医院骨一科;贵州省人民医院骨科;
【分类号】：R687.3

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