CAJ | 학술논문

目的：比较改良动力髋螺钉与股骨近端髄内钉（ PFN）治疗老龄股骨粗隆间骨折的方法及疗效。方法：对60例老龄股骨粗隆间骨折的患者，随机运用改良DHS与PFN治疗，比较2组术后并发症及关节功能。结果：2组比较： DHS组在切口长度、手术时间及术中出血量均大于PFN组，差异具有统计学意义（P＜0．05）。术后1年：DHS组出现滑动髁螺钉退出3例，切割股骨头穿出1例，均发生于Ⅳ型骨折。其中出现髋内翻2例，发生于内侧结构不稳病例。 PFN组无内固定断裂及髋内翻等并发症发生，出现2例螺钉退出，2组并发症比较（p＜0．05）差异有统计学意义。 Harris髋关节评分PFN优于DHS组，但2组比较（p＞0．05）差异无统计学意义。结论：2种手术治方法均有各自优势，对于粉碎性或骨质疏松性股骨粗隆间骨折，宜选用PFN治疗。
목적：비교개량동력관라정여고골근단수내정（ PFN）치료노령고골조륭간골절적방법급료효。방법：대60례노령고골조륭간골절적환자，수궤운용개량DHS여PFN치료，비교2조술후병발증급관절공능。결과：2조비교： DHS조재절구장도、수술시간급술중출혈량균대우PFN조，차이구유통계학의의（P＜0．05）。술후1년：DHS조출현활동과라정퇴출3례，절할고골두천출1례，균발생우Ⅳ형골절。기중출현관내번2례，발생우내측결구불은병례。 PFN조무내고정단렬급관내번등병발증발생，출현2례라정퇴출，2조병발증비교（p＜0．05）차이유통계학의의。 Harris관관절평분PFN우우DHS조，단2조비교（p＞0．05）차이무통계학의의。결론：2충수술치방법균유각자우세，대우분쇄성혹골질소송성고골조륭간골절，의선용PFN치료。
objective:To compare the improved dynamic hip screw and the proximal femoral marrow inner nail ( PFN) aging treatment of intertrochanteric fractures of the method and curative effect .Methods:60 cases of elderly patients with intertrochanteric fracture , a ran-dom using modified PFN and DHS treatment , compared two groups of postoperative complications and joint function .Results:Two groups of comparisons:DHS group in incision length, operative time and intraoperative blood loss were greater than PFN group , difference has statistical significance (P <0.05).One year after surgery: DHS group appear sliding condyle screw exit 3 cases, cutting wear out in 1 case, femoral head occurred in Ⅳtype fractures.Including a hip varus in 2 cases,unstable cases happens on the inside of the structure . PFN group internal fixation of fracture and complications , such as hip varus in 2 cases of screw exit , compare of complications in two groups ( p <0.05) difference was statistically significant .Harris hip score PFN is better than DHS group , but compared two groups there was no statistically significant difference (p >0.05).Conclusion:Two kinds of surgical methods may have their respective advantages , for comminuted or osteoporotic intertrochanteric fractures , appropriate chooses PFN treatment .