CAJ | 학술논문

目的比较分析股骨近端螺旋刀片抗旋髓内钉(PFNA)、动力髋螺钉(DHS)、殷骨近端锁定加压钢板(LCP)治疗老年股骨转子间骨折的疗效.方法选择73例老年股骨转子间骨折患者,按内固定方法不同分为:PFNA组30例采用PFNA内固定治疗,DHS组22例采用DHS内固定治疗,LCP组21例采用LCP内固定治疗.比较三组手术时间、术中出血量、骨折愈合时间、患肢负重时间及髋关节功能评分.结果 PFNA组、DHS组、LCP组手术时间分别为(73.9±8.5)、(82.3±10.6)、(79.5±11.2) min,PFNA组与DHS组比较差异有统计学意义(P＜0.05),与LCP组比较差异无统计学意义(P＞ 0.05);PFNA组术中出血量明显少于DHS组和LCP组[(160.2±15.6)ml比(208.4±20.2)、(216.6±24.9) ml],差异有统计学意义(P＜ 0.05);PFNA组骨折愈合时间、患肢负重时间明显短于DHS组和LCP组[(97.4±5.8)d比(101.2±4.2)、(110.0±8.3)d和(78.0±5.4)d比(85.9±7.6)、(90.8±6.0)d],DHS组明显短于LCP组,三组间比较差异有统计学意义(P＜0.05).三组髋关节功能评分优良率比较差异无统计学意义(P＞ 0.05).结论 PFNA对治疗老年股骨转子间骨折相对于DHS、LCP有着更好的疗效,更小的手术创伤,缩短了恢复时间,是治疗老年股骨转子间骨折的理想方法.
목적 비교분석고골근단라선도편항선수내정(PFNA)、동력관라정(DHS)、은골근단쇄정가압강판(LCP)치료노년고골전자간골절적료효.방법 선택73례노년고골전자간골절환자,안내고정방법불동분위:PFNA조30례채용PFNA내고정치료,DHS조22례채용DHS내고정치료,LCP조21례채용LCP내고정치료.비교삼조수술시간、술중출혈량、골절유합시간、환지부중시간급관관절공능평분.결과 PFNA조、DHS조、LCP조수술시간분별위(73.9±8.5)、(82.3±10.6)、(79.5±11.2) min,PFNA조여DHS조비교차이유통계학의의(P＜0.05),여LCP조비교차이무통계학의의(P＞ 0.05);PFNA조술중출혈량명현소우DHS조화LCP조[(160.2±15.6)ml비(208.4±20.2)、(216.6±24.9) ml],차이유통계학의의(P＜ 0.05);PFNA조골절유합시간、환지부중시간명현단우DHS조화LCP조[(97.4±5.8)d비(101.2±4.2)、(110.0±8.3)d화(78.0±5.4)d비(85.9±7.6)、(90.8±6.0)d],DHS조명현단우LCP조,삼조간비교차이유통계학의의(P＜0.05).삼조관관절공능평분우량솔비교차이무통계학의의(P＞ 0.05).결론 PFNA대치료노년고골전자간골절상대우DHS、LCP유착경호적료효,경소적수술창상,축단료회복시간,시치료노년고골전자간골절적이상방법.
Objective To analyze the operative therapeutic effect of proximal femoral nail antirotation blade (PFNA),dynamic hip screw (DHS) and femoral proximal locking compression plate (LCP)internal fixation in treatment with femoral intertrochanteric fracture of the aged.Methods Seventy-three aged patients with femoral intertrochanteric fracture were divided into 3 groups according to different internal fixation method:PFNA group (30 cases) was treated with PFNA internal fixation,DHS group (22 cases) was treated with DHS internal Fxation,LCP group (21 cases) was treated with LCP internal fixation.The operative time,intraoperative bleeding volume,fracture healing time,bad limb load time and hip joint function score were compared among the 3 groups.Results The operative time in PFNA group,DHS group and LCP group was (73.9 ± 8.5),(82.3 ± 10.6),(79.5 ± 11.2) min,there was statistical difference between PFNA group and DHS group (P ＜ 0.05),but there was no statistical difference between PFNA group and LCP group (P＞ 0.05).The intraoperative bleeding volume in PFNA group was significantly lower than that in DHS group and LCP group [(160.2 ± 15.6) ml vs.(208.4 ± 20.2) and (216.6 ml ± 24.9) ml],there was statistical difference (P ＜0.05).The fracture healing time and bad limb load time in PFNA group were significantly shorter than those in DHS group and LCP group [(97.4 ± 5.8) d vs.(101.2 ± 4.2),(110.0 ±8.3) d and (78.0 ±5.4) d vs.(85.9 ±7.6),(90.8±6.0) d],furtbermore DHS group were significantly shorter than those in LCP group,there were statistical differences among the 3 groups (P ＜ 0.05).There were no statistical differences in excellent and good rate of hip joint function score among the 3 groups (P ＞ 0.05).Conclusions PFNA is the ideal therapeutic method for femoral intertrochanteric fracture of the aged.It has better curative effect compared to the DHS and LCP,and has less surgical trauma and can shorten the recovery time.