CAJ | 학술논문

目的：比较动力髋螺钉(DHS)固定、近端锁定板(PLP)固定、近端解剖板(PAP)固定及人工关节置换(AJR)等4种手术方式治疗股骨转子间骨折的安全性和疗效。方法对318例在本院手术治疗的股骨转子间骨折患者的临床资料进行回顾性分析，按照手术方式分为DHS组、PLP组、PAP组及AJR组，比较各组的平均手术时间、术中出血量、术中输血量、手术相关并发症发生情况、愈合时间及Harris髋关节功能评分。结果 PLP组手术时间最短，与其他3组比较差异有统计学意义(P<0.05)；DHS组术中出血量及术中输血量最多，与其他3组比较差异有统计学意义(P<0.01)；PLP组骨折愈合时间最短，与其他3组比较差异有统计学意义(P<0.01)；PLP组Harris髋关节功能评分最高，但各组间比较差异无统计学意义(P>0.05)；DHS组、PLP组、PAP组、AJR组手术相关并发症发生率分别为7.14%、3.09%、8.33%、9.80%，各组间比较，差异无统计学意义(均P>0.05)。结论 DHS、PLP、PAP、AJR等4种手术方式各具不同的优缺点，但PLP在手术安全性和疗效方面较其他3种手术方式更具有一定优势。
목적：비교동력관라정(DHS)고정、근단쇄정판(PLP)고정、근단해부판(PAP)고정급인공관절치환(AJR)등4충수술방식치료고골전자간골절적안전성화료효。방법대318례재본원수술치료적고골전자간골절환자적림상자료진행회고성분석，안조수술방식분위DHS조、PLP조、PAP조급AJR조，비교각조적평균수술시간、술중출혈량、술중수혈량、수술상관병발증발생정황、유합시간급Harris관관절공능평분。결과 PLP조수술시간최단，여기타3조비교차이유통계학의의(P<0.05)；DHS조술중출혈량급술중수혈량최다，여기타3조비교차이유통계학의의(P<0.01)；PLP조골절유합시간최단，여기타3조비교차이유통계학의의(P<0.01)；PLP조Harris관관절공능평분최고，단각조간비교차이무통계학의의(P>0.05)；DHS조、PLP조、PAP조、AJR조수술상관병발증발생솔분별위7.14%、3.09%、8.33%、9.80%，각조간비교，차이무통계학의의(균P>0.05)。결론 DHS、PLP、PAP、AJR등4충수술방식각구불동적우결점，단PLP재수술안전성화료효방면교기타3충수술방식경구유일정우세。
Objective To compare the operation safety and effect of four different surgical procedures including dynam-ic hip screw (DHS) fixation,proximal lock plate (PLP) fixation,proximal anatomical plate (PAP) fixation and artificial joint replacement (AJR) in the treatment of intertrochanteric fracture. Methods Clinical data from 318 patients with in-tertrochanteric fracture accepted surgical treatment in our hospital were retrospectively analyzed.According to different surgical procedures,they were divided into four groups: DHS group,PLP group,PAP group,and AJR group.The average operation time,intraoperative amount of bleeding,intraoperative blood transfusion,complications related to surgery,healing time,and Harris hip joint function scoring were compared among these four groups. Results The operation time in PLP group was shortest with statistical differences in comparison with the other three groups separately (P<0.05).The intra-operative amount of bleeding and transfusion in DHS group were most,which displayed statistical differences after com-paring with the other three groups one by one (P<0.01).The fracture healing time in PLP group was shortest,and dis-played statistical differences after comparing with the other three groups (P<0.01).Score of Harris hip joint function was highest in PLP group,but there was no significant difference among these groups (P>0.05).The incidences of complica-tions related to surgery in DHS group,PLP group,PAP group,and AJR group were 7.14%,3.09%,8.33%,and 9.80% re-spectively.After comparison,the incidence in PLP group was lowest,but there was no statistical difference between each two groups (P>0.05). Conclusion Four different surgical procedures including DHS,PLP,PAP,and AJR have different ad-vantages and disadvantages.Operation safety and effect of PLP gets certain superiority in comparison of other three sur-gical procedures.