实用骨科杂志
實用骨科雜誌
실용골과잡지
JOURNAL OF PRACTICAL ORTHOPEDICS
2014年
10期
888-890,891
,共4页
倪晓辉%朱兴元%田顺林%刘晓冬%张卢
倪曉輝%硃興元%田順林%劉曉鼕%張盧
예효휘%주흥원%전순림%류효동%장로
股骨粗隆间骨折%股骨近端抗旋髓内钉%动力髋螺钉%对比
股骨粗隆間骨摺%股骨近耑抗鏇髓內釘%動力髖螺釘%對比
고골조륭간골절%고골근단항선수내정%동력관라정%대비
intertrochanteric%fractures%proximal femoral nail anti-rotation%dynamic hip screw%comparison
目的：探讨股骨近端抗旋髓内钉（ proximal femoral nail anti-rotation，PFNA）和动力髋螺钉（ dynamic hip screw，DHS）治疗老年人股骨粗隆间骨折的临床疗效。方法对2008年1月至2011年1月41例老年股骨粗隆间骨折患者的临床资料及手术结果进行回顾性分析，其中PFNA组17例，DHS组24例。对两组患者的一般资料、手术时间、术中出血量、骨折平均愈合时间、负重时间、髋关节功能恢复情况等进行统计学分析。结果 PFNA组较DHS组平均手术时间短（t=2.704，P=0.018），术中出血少（t=5.009，P=0.006），术后负重时间早（t=2.899，P=0.017），以及术后骨折复位丢失、髋内翻畸形率低（χ2=4.490，P=0.039）。髋关节功能按Harris评分标准进行评价，PFNA组优8例，良7例，可1例，差1例，优良率88.2%；DHS组优9例，良6例，可5例，差4例，优良率62.5%；两组差异有统计学意义（χ2=4.042，P=0.047）。两组在术后骨折愈合时间方面差异无统计学意义（ P>0.05）。结论 PFNA治疗股骨粗隆间骨折具有微创、固定牢稳、术后可进行早期功能锻炼、并发症少等优点，是治疗老年人股骨粗隆间骨折的理想方法。
目的：探討股骨近耑抗鏇髓內釘（ proximal femoral nail anti-rotation，PFNA）和動力髖螺釘（ dynamic hip screw，DHS）治療老年人股骨粗隆間骨摺的臨床療效。方法對2008年1月至2011年1月41例老年股骨粗隆間骨摺患者的臨床資料及手術結果進行迴顧性分析，其中PFNA組17例，DHS組24例。對兩組患者的一般資料、手術時間、術中齣血量、骨摺平均愈閤時間、負重時間、髖關節功能恢複情況等進行統計學分析。結果 PFNA組較DHS組平均手術時間短（t=2.704，P=0.018），術中齣血少（t=5.009，P=0.006），術後負重時間早（t=2.899，P=0.017），以及術後骨摺複位丟失、髖內翻畸形率低（χ2=4.490，P=0.039）。髖關節功能按Harris評分標準進行評價，PFNA組優8例，良7例，可1例，差1例，優良率88.2%；DHS組優9例，良6例，可5例，差4例，優良率62.5%；兩組差異有統計學意義（χ2=4.042，P=0.047）。兩組在術後骨摺愈閤時間方麵差異無統計學意義（ P>0.05）。結論 PFNA治療股骨粗隆間骨摺具有微創、固定牢穩、術後可進行早期功能鍛煉、併髮癥少等優點，是治療老年人股骨粗隆間骨摺的理想方法。
목적：탐토고골근단항선수내정（ proximal femoral nail anti-rotation，PFNA）화동력관라정（ dynamic hip screw，DHS）치료노년인고골조륭간골절적림상료효。방법대2008년1월지2011년1월41례노년고골조륭간골절환자적림상자료급수술결과진행회고성분석，기중PFNA조17례，DHS조24례。대량조환자적일반자료、수술시간、술중출혈량、골절평균유합시간、부중시간、관관절공능회복정황등진행통계학분석。결과 PFNA조교DHS조평균수술시간단（t=2.704，P=0.018），술중출혈소（t=5.009，P=0.006），술후부중시간조（t=2.899，P=0.017），이급술후골절복위주실、관내번기형솔저（χ2=4.490，P=0.039）。관관절공능안Harris평분표준진행평개，PFNA조우8례，량7례，가1례，차1례，우량솔88.2%；DHS조우9례，량6례，가5례，차4례，우량솔62.5%；량조차이유통계학의의（χ2=4.042，P=0.047）。량조재술후골절유합시간방면차이무통계학의의（ P>0.05）。결론 PFNA치료고골조륭간골절구유미창、고정뢰은、술후가진행조기공능단련、병발증소등우점，시치료노년인고골조륭간골절적이상방법。
Objective To compare the clinical results of PFNA fixation and DHS fixation of intertrochanteric fractures. Methods Seventeen patients who had received PFNA fixation and 24 ones who had DHS fixation of intertrochanteric fractures in our hospital between January 2008 to January 2011 were involved in our retrospective investigation. The clinic data,operation time,intraoperative blood loss,fracture healing time,postoperative weight loading time,functions of the hip joint of the 2 groups were all statistically compared in our study. Results The average operation time of PFNA fixation group was shorter than DHS fixation group(t=2. 704,P=0. 018),and the blood loss was lesser(t=5. 009,P=0. 006),the postoperative weight loading time was earlier( t =2 . 8 9 9 ,P =0 . 0 1 7 ),the incidence of dislocation of fracture or hip varus was lower(χ2 =4 . 4 9 0 ,P =0. 039). According to Harris standard,PFNA fixation group were excellent in 8 cases,good in 7 cases,fair in 1cases and poor in 1 case,the rate of excellent and good was 88. 2%,while DHS fixation group were excellent in 9 cases,good in 6 cases,fair in 5 cases and poor in 4 case,the rate of excellent and good was 62. 5 %,and there was a significant difference(χ2 =4. 042, P=0. 047). There was no significant difference between the 2 groups in the fracture healing time(P>0. 05). Conclusion PFNA fixation of intertrochanteric fractures is a treatment of elder patients with intertrochanteric fractures as a good way.
