临床骨科杂志
臨床骨科雜誌
림상골과잡지
JOURNAL OF CLINICAL ORTHOPAEDICS
2014年
2期
161-163,164
,共4页
赵耀杰%陈军%李凯军%雷哲倩%王栋梁
趙耀傑%陳軍%李凱軍%雷哲倩%王棟樑
조요걸%진군%리개군%뢰철천%왕동량
股骨转子间骨折%防旋股骨近端髓内钉%动力髋螺钉
股骨轉子間骨摺%防鏇股骨近耑髓內釘%動力髖螺釘
고골전자간골절%방선고골근단수내정%동력관라정
intertrochanteric fracture%proximal femoral nail antirotation%dynamic hip screw
目的：比较防旋股骨近端髓内钉（PFNA）和动力髋螺钉（DHS）治疗股骨转子间骨折的临床疗效。方法121例股骨转子间骨折患者随机化采用PFNA（n＝58例，PFNA组）和DHS（n＝63例，DHS组）治疗。记录两组透视时间、手术时间、术中出血量、住院天数、下地行走时间、骨折愈合时间、并发症情况，并进行Harris评分。结果121例均获随访，时间1～3年。手术时间：PFNA组38～70（52±10）min，DHS组45～125（93±13）min，P＝0.002。透视时间：PFNA组5～10（7±3）min，DHS组2～7（5±2）min，P＝0.003。出血量：PFNA组60～210（156±24）ml，DHS组350～720（410±65）ml，P＝0.008。下地时间：PFNA组4～9（6.2±1.5）周， DHS组6～10（8.7±1.3）周，P＝0.001。住院天数：PFNA组7～13（9.8±2.4）d，DHS组7～12（9.2±2.7） d，P＝0.671。骨折愈合时间：PFNA组7～12（9.8±2.3）周，DHS组7～11（9.3±2.4）周，P＝0.486。术后并发症发生率：PFNA 组1.7％，DHS 组6.3％，P ＝0.071。临床优良率：PFNA 组87.9％，DHS 组92.1％， P＝0.785。结论 PFNA和DHS治疗股骨转子间骨折，均能取得满意的临床疗效，但是PFNA创伤较小，再手术率较低。
目的：比較防鏇股骨近耑髓內釘（PFNA）和動力髖螺釘（DHS）治療股骨轉子間骨摺的臨床療效。方法121例股骨轉子間骨摺患者隨機化採用PFNA（n＝58例，PFNA組）和DHS（n＝63例，DHS組）治療。記錄兩組透視時間、手術時間、術中齣血量、住院天數、下地行走時間、骨摺愈閤時間、併髮癥情況，併進行Harris評分。結果121例均穫隨訪，時間1～3年。手術時間：PFNA組38～70（52±10）min，DHS組45～125（93±13）min，P＝0.002。透視時間：PFNA組5～10（7±3）min，DHS組2～7（5±2）min，P＝0.003。齣血量：PFNA組60～210（156±24）ml，DHS組350～720（410±65）ml，P＝0.008。下地時間：PFNA組4～9（6.2±1.5）週， DHS組6～10（8.7±1.3）週，P＝0.001。住院天數：PFNA組7～13（9.8±2.4）d，DHS組7～12（9.2±2.7） d，P＝0.671。骨摺愈閤時間：PFNA組7～12（9.8±2.3）週，DHS組7～11（9.3±2.4）週，P＝0.486。術後併髮癥髮生率：PFNA 組1.7％，DHS 組6.3％，P ＝0.071。臨床優良率：PFNA 組87.9％，DHS 組92.1％， P＝0.785。結論 PFNA和DHS治療股骨轉子間骨摺，均能取得滿意的臨床療效，但是PFNA創傷較小，再手術率較低。
목적：비교방선고골근단수내정（PFNA）화동력관라정（DHS）치료고골전자간골절적림상료효。방법121례고골전자간골절환자수궤화채용PFNA（n＝58례，PFNA조）화DHS（n＝63례，DHS조）치료。기록량조투시시간、수술시간、술중출혈량、주원천수、하지행주시간、골절유합시간、병발증정황，병진행Harris평분。결과121례균획수방，시간1～3년。수술시간：PFNA조38～70（52±10）min，DHS조45～125（93±13）min，P＝0.002。투시시간：PFNA조5～10（7±3）min，DHS조2～7（5±2）min，P＝0.003。출혈량：PFNA조60～210（156±24）ml，DHS조350～720（410±65）ml，P＝0.008。하지시간：PFNA조4～9（6.2±1.5）주， DHS조6～10（8.7±1.3）주，P＝0.001。주원천수：PFNA조7～13（9.8±2.4）d，DHS조7～12（9.2±2.7） d，P＝0.671。골절유합시간：PFNA조7～12（9.8±2.3）주，DHS조7～11（9.3±2.4）주，P＝0.486。술후병발증발생솔：PFNA 조1.7％，DHS 조6.3％，P ＝0.071。림상우량솔：PFNA 조87.9％，DHS 조92.1％， P＝0.785。결론 PFNA화DHS치료고골전자간골절，균능취득만의적림상료효，단시PFNA창상교소，재수술솔교저。
Objective To compare the outcome of proximal femoral nail antirotation (PFNA)or dynamic hip screws (DHS)in the treatment of intertrochanteric fractures.Methods 121 patients with intertrochanteric fractures were randomized to treat with PFNA (n=58,PFNA group)or DHS (n=63,DHS group).These data of the both group were recorded,including the operative time,blood loss,fluoroscopy time,length of hospital stay,walking time,u-nion time,complications,and Harris score.Results All of 121 patients were followed up for 1 ~3 years.There were significant difference between the both groups in term of the operative time:PFNA group 38~70 (52 ±10)min, DHS group 45 ~125(93 ±13)min,P=0.002.Fluoroscopy time:PFNA group 5 ~10 (7 ±3)min,DHS group 2~7(5 ±2)min,P=0.003.Blood loss:PFNA group 60~210 (156 ±24)ml,DHS group 350~720 (410 ±65)ml, P=0.008.Walking time:PFNA group 4 ~9 (6.2 ±1.5 )weeks,DHS group 6 ~10 (8.7 ±1.3 )weeks,P=0.001.There were no significant difference between the two groups in term of the length of hospital stay PFNA group 7~13(9.8 ±2.4)days,DHS group 7~12 (9.2 ±2.7)days,P=0.671.Union time:PFNA group 7~12 (9.8 ± 2.3)weeks,DHS group 7~11 (9.3 ±2.4)weeks,P=0.486.Complications rate:PFNA group 1.7%,DHS group 6.3%,P=0.07 1 .The incidence of good to excellent clinical outcomes:PFNA group 87.9%,DHS group 92.1%,P=0.785 .Conclusions Many patients with intertrochanteric fractures can achieve good to excellent outcomes in treatment of the PFNA or DHS,but the PFNA has more advantages in less injury and low reoperation rate.
