CAJ | 학술논문

目的：比较股骨近端防旋髓内钉(PFNA)和动力髋螺钉(DHS)内固定术式治疗股骨转子间骨折的临床效果。方法选择本院2008年7月~2013年6月收治的57例股骨转子间骨折患者为研究对象，根据内固定方式的不同分为PFNA组28例和DHS组29例。比较两组的手术相关指标、优良率以及并发症情况。结果两组的住院时间、骨折愈合时间比较差异均无统计学意义(P>0.05)，但PFNA组的手术时间、负重时间均短于DHS组，术中出血量少于DHS组(P<0.05)。对于稳定型骨折，两组的优良率差异无统计学意义(P>0.05)，对于不稳定型骨折，PFNA组的优良率显著高于DHS组，差异有统计学意义(P<0.05)。结论 PFNA、DHS均为治疗稳定型股骨转子间骨折的可行方法，但PFNA较DHS具有手术时间短、出血少的优势，尤其是对于不稳定型股骨转子间骨折。临床上外科医生应根据骨折类型和患者的特点来谨慎选择手术方式。
목적：비교고골근단방선수내정(PFNA)화동력관라정(DHS)내고정술식치료고골전자간골절적림상효과。방법선택본원2008년7월~2013년6월수치적57례고골전자간골절환자위연구대상，근거내고정방식적불동분위PFNA조28례화DHS조29례。비교량조적수술상관지표、우량솔이급병발증정황。결과량조적주원시간、골절유합시간비교차이균무통계학의의(P>0.05)，단PFNA조적수술시간、부중시간균단우DHS조，술중출혈량소우DHS조(P<0.05)。대우은정형골절，량조적우량솔차이무통계학의의(P>0.05)，대우불은정형골절，PFNA조적우량솔현저고우DHS조，차이유통계학의의(P<0.05)。결론 PFNA、DHS균위치료은정형고골전자간골절적가행방법，단PFNA교DHS구유수술시간단、출혈소적우세，우기시대우불은정형고골전자간골절。림상상외과의생응근거골절류형화환자적특점래근신선택수술방식。
Objective To compare clinical effect of proximal femoral nail anti-rotation (PFNA) and dynamic hip screw (DHS) for internal fixation in the treatment of intertrochanteric fracture. Methods 67 patients with intertrochanteric fracture treated in our hospital from July 2008 to June 2013 were selected as study objects.All cases were divided into DHS group (n=28) and PFNA group (n=29) according to the internal fixation method.The indicators related to the oper-ation,good and excellent rate,and complication were compared between two groups. Results There were no statistical difference of hospital stay and fracture healing time between two groups (P>0.05).Operation time and load time of PFNA group was shorter than that of DHS group respectively (P<0.05),bleeding amount during operation of PFNA group was fewer than that of DHS group (P<0.05).For stable fracture,there was no statistical difference of excellent and good rate between two groups,but for unstable fracture,excellent and good rate of PFNA group was significantly higher than that of DHS group (P<0.05). Conclusion Both PFNA and DHS are possible ways to treat stable intertrochanteric fracture,but PFNA has the advantage of shorter surgical time and fewer bleeding amount,but for unstable intertrochanteric fracture, PFNA is superior to DHS.Surgeons should select the surgical method according to the fracture type and characteristic of patients.