老年股骨粗隆间骨折三种内固定方式治疗的疗效比较

雷军1 ，王军伟2

（1.西安市高陵区医院骨科，陕西 西安，710200；2.西安市红会医院关节外科，陕西 西安，710000）

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摘要：

目的 比较动力髋螺钉（DHS）、股骨近端解剖型锁定钛板（ALP）与股骨近端抗旋髓内钉（PFNA）治疗老年股骨粗隆间骨 折的疗效。方法 回顾性分析2009年1月至2015年9月收治的106例老年股骨粗隆间骨折患者的临床资料，35例患者采用 DHS内固定（DHS组）；34例患者采用锁定板（ALP组）；37例患者采用PFNA内固定（PFNA组）。比较三组患者的手术时间、术中出血量、术后引流量、骨折愈合时间。髋关节Harris 评分及并发症的发生率等。结果 PFNA组患者手术时间、术中出血 量、术后引流量、骨折愈合时间优于DHS组和ALP组；患者髋关节Harris 评分显著高于DHS组和ALP组；PFNA组并发症总 发生率低于DHS组和ALP组，差异均有统计学意义（P<0.05）。结论 DHS、ALP 及PFNA 均可用于治疗老年股骨粗隆间骨折，但对于老年的股骨粗隆间骨折PFNA固定更适宜。PFNA 内固定治疗老年股骨粗隆间骨折效果更理想。

关键词：股骨骨折；DHS 钢板；ALP 钛板；PFNA 髓内钉

中图分类号：R687.3文献标志码：A文章编号：2096-1413(2017)32-0076-03

Effect comparion of three kinds of internal fixation treatment in elderly patients with femoral intertrochanteric fracture
LEI Jun 1, WANG Jun-wei 2
(1. Department of Orthopaedic, Xi``an Gaoling District Hospital, Xi``an 710200; 2. Department of Joint Surgery, Xi``an Honghui Hospital, Xi``an 710000, China)

ABSTRACT: Objective To compare the curative effect of the dynamic hip screw (DHS), proximal femur anatomic locking titanium plate (ALP) and proximal femur anti rotary intramedullary nailing (PFNA) in the treatment of femoral intertrochanteric fracture. Methods A retrospective analysis of 106 cases of elderly patients with femoral intertrochanteric fracture from January 2009 to September 2015 was performed. Thirty-five patients receiving DHS internal fixation were selected as the DHS group, 34 cases treated by locking plate were selected as the ALP group, 37 cases receiving internal fixation with PFNA were selected as the PFNA group. The operation time, intraoperative blood loss, postoperative flow, fracture healing time, the Harris hip scores and the incidence of complications of the three groups were compared. Results The operating time, intraoperative blood loss, the flow rate and fracture healing time of the PFNA group were better than those of the DHS group and ALP group; the Harris hip scores of PFNA group was higher than that of the DHS group and ALP group; the incidence of complications of the PFNA group was lower than that of the DHS group and ALP group, all the above differences were statistically significont (P<0.05). Conclusion DHS, ALP and PFNA can be used in the treatment of senile femoral intertrochanteric fracture, but PFNA intertrochanteric fractures fixtion was more appropriate for the elderly. The effect of PFNA in elderly patients with femoral intertrochanteric fractures is more ideal.
KEYWORDS: femur fracture; DHS steel; ALP titanium plate; PFNA intramedullary nail

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