CAJ | 학술논문

目的：比较第四代股骨髓内钉InterTAN、股骨近端防旋髓内钉PFNA和髋动力钢板DHS治疗股骨转子间骨折的疗效．方法：回顾性分析应用InterTAN和PFNA两种不同器械治疗股骨转子间骨折的72例病例，并选择同期使用DHS的23例病例对比，其中总的83例得到了4至16个月不等的随访．比较这三种手术的手术时间和术中出血量．随访时记录术后下床时间以及参照Sanders髋关节功能评分对患者髋关节的功能进行评定．结果：DHS组比InterTAN组和PFNA组手术时间都长（P＜0.05），而InterTAN组和PFNA组间手术时间是差异无显著性意义（P＞0.05）．DHS组、InterTAN组和PFNA组手术出血上差异有显著性意义（P＜0.05），出血最多的为DHS组，出血最少的是InterTAN组．DHS组比InterTAN组和PFNA组下地时间更延后（P＜0.05），而InterTAN 组和PFNA组间下地时间上差异无显著性意义（P＞0.05）；Sanders髋关节功能评分比较后发现三组患者术后功能优良率的差异无显著性意义（P＞0.05）．结论：PFNA、InterTAN 符合骨折的微创手术要求，与传统的DHS 相比，PFNA和InterTAN在股骨转子间骨折的治疗中有更多的优越性．
목적：비교제사대고골수내정InterTAN、고골근단방선수내정PFNA화관동력강판DHS치료고골전자간골절적료효．방법：회고성분석응용InterTAN화PFNA량충불동기계치료고골전자간골절적72례병례，병선택동기사용DHS적23례병례대비，기중총적83례득도료4지16개월불등적수방．비교저삼충수술적수술시간화술중출혈량．수방시기록술후하상시간이급삼조Sanders관관절공능평분대환자관관절적공능진행평정．결과：DHS조비InterTAN조화PFNA조수술시간도장（P＜0.05），이InterTAN조화PFNA조간수술시간시차이무현저성의의（P＞0.05）．DHS조、InterTAN조화PFNA조수술출혈상차이유현저성의의（P＜0.05），출혈최다적위DHS조，출혈최소적시InterTAN조．DHS조비InterTAN조화PFNA조하지시간경연후（P＜0.05），이InterTAN 조화PFNA조간하지시간상차이무현저성의의（P＞0.05）；Sanders관관절공능평분비교후발현삼조환자술후공능우량솔적차이무현저성의의（P＞0.05）．결론：PFNA、InterTAN 부합골절적미창수술요구，여전통적DHS 상비，PFNA화InterTAN재고골전자간골절적치료중유경다적우월성．
Aim:Comparison of the curative effect on treatmeant of intertrochanteric fracture with In-terTAN、PFNA and DHS.Methods:Seventy-two cases of intertrochanteric fracture patients who treated with InterTAN and PFNA were respectively reviewed.In this period 23 intertro-chanteric fracture patients treated with DHS were chosen as the control group.83 patients were followed-up from 4 months to1 6 months.The hip function was evaluated 4 months at least after operation by the Sanders scores.Results:there was no significant difference of statistics in operating time between InterTAN group and PFNA group (P>0.05 ),while the time of DHS group was more than that of these two groups (P<0.05 ).There was no significant difference of statistics in the time of the first standing up after operation between InterTAN group and PFNA group (P>0.05 ),while the time of DHS was later than these two groups(P<0.05 ). There was significant difference of statistics in the operation bleeding loss among those groups (P <0.05 ).According to Sanders scores for hip joint function,There was no significant difference of statistics in excellent rate among those groups (P>0.05 ).Conclusion:For the intertrochanteric fractures,Inter-TAN、PFNA and DHS can be used,but InterTAN and PFNA are the better choice of intramedullary nail in intertrochanteric fractures treatment.