DHS与PFNA治疗高龄患者转子间骨折的手术对比(1)
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[摘要] 目的：探讨动力髋螺钉(DHS)与螺旋刀片型股骨近端髓内钉(PFNA)治疗高龄患者转子间骨折的手术对比情况，为临床治疗高龄转子间骨折采用合理的手术方法提供依据。方法：60例高龄转子间骨折患者分为对照组和治疗组，每组各30例。分别采用基于DHS、PFNA的手术方法治疗。结果：治疗组较对照组手术时间短，出血量和引流量少，差异有统计学意义(P<0.05)。随访后，治疗组的髋关节功能优良率为90.0%，对照组的髋关节功能优良率为76.7%，两组比较差异有统计学意义(P<0.05)。结论：PFNA应用于高龄患者转子间骨折可明显降低手术的手术时间、出血量和引流量，同时有利于髋关节功能的恢复，值得临床推广应用。
[关键词] 转子间骨折；高龄人；动力髋螺钉；螺旋刀片型股骨近端髋内钉
[中图分类号] R683 [文献标识码] B [文章编号] 1673-7210(2011)11(c)-184-02
Surgery comparing of DHS and PFNA for treating intertrochanteric fractures in elderly patients
LI Haobo, HE Jianjun, TANG Changyou, LIU Hong, LING Min
Department of Orthopedic, the Fourth Hospital of Changsha City, Hu′nan Province, Changsha 410006, China
[Abstract] Objective: To investigate the surgery comparing of DHS and PFNA in treating intertrochanteric fractures in elderly patients and to give a reasonable basis for clinical treatment of intertrochanteric fractures. Methods: 60 patients with intertrochanteric fractures were equally divided into two groups, the control group (n=30) and treatment group (n=30), the two groups were given the based on DHS or PFNA of surgical treatment. Results: The operative time, blood loss and drainage of the treatment group were less than those of the control group, the differences were significant (P<0.05). After the follow up, the treatment group of hip joint function fine rate was 90.0%, the control group was 76.7%, the differece was significant between the two groups (P<0.05). Conclusion: PFNA applications intertrochanteric fractures in elderly people in surgery can significantly reduce operation time, blood loss and drainage, it is also conducive to the recovery of hip function, worthy of clinical application.
[Key words] Intertrochanteric fracture; Elderly people; DHS; PFNA
转子间骨折是临床常见髋部骨折之一，好发于高龄人，保守治疗一般不太好，预后差[1-3]。随着我国经济社会的转变，转子间骨折发病率有逐年上升趋势[4]。同时高龄患者预后要求高，手术难度增大。随着医学及科技的发展，内固定器材被逐渐应用到手术当中，但是不同的手术方法疗效差异较大，难以达成一致意见[5]。笔者对我院2010年2~10月60例高龄转子间骨折患者分别采用基于动力髋螺钉(DHS)或螺旋刀片型股骨近端髋内钉(PFNA)的手术方法治疗，取得了不同的效果，现将治疗结果报道如下：
1 资料与方法
1.1 一般资料
2010年2~10月选取我院收治的高龄转子间骨折患者60例[7]。其中，男32例，女28例。年龄54~83岁，平均65.5岁。受伤原因：跌倒伤40例，道路交通伤10例，高处坠落伤5例，扭伤3例，其他2例。右侧40例，左侧20例。骨折Garden分型Ⅲ型40例 ......
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