[1]卢冰,王跃,刘攀,等.髓内钉及动力髋螺钉治疗老年稳定性股骨转子间骨折的比较[J].中华老年骨科与康复电子杂志,2017,(05):260-264.[doi:10.3877/cma.j.issn.2096-0263.2017.05.002]
　Lu Bing,Wang Yue,Liu Pan,et al.Comparison of the clinical efficacy between proximal femoral nail and DHS in the treatment of elderly patients with intertrochanteric fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):260-264.[doi:10.3877/cma.j.issn.2096-0263.2017.05.002]
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髓内钉及动力髋螺钉治疗老年稳定性股骨转子间骨折的比较()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年05期
页码:
260-264
栏目:
髋部骨折
出版日期:
2017-09-18

文章信息/Info

Title:
Comparison of the clinical efficacy between proximal femoral nail and DHS in the treatment of elderly patients with intertrochanteric fractures
作者:
卢冰; 王跃; 刘攀; 鲜爱明
610072 成都，四川省医学科学院，四川省人民医院骨科
Author(s):
Lu Bing;  Wang Yue;  Liu Pan;  Xian Aiming
Department of Orthopedics, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu 610072, China
关键词:
老年人;  髋骨折;  骨折固定术; 内
Keywords:
Aged;  Hip fractures;  Fracture fixation;  internal
DOI:
10.3877/cma.j.issn.2096-0263.2017.05.002
文献标志码:
A
摘要:
目的 比较股骨近端髓内钉（PFN）及动力髋螺钉（DHS）治疗老年稳定性股骨转子间骨折的临床疗效。方法 回顾性分析2010年5月至2014年5月，四川省人民医院骨科收治的76例老年稳定性股骨转子间骨折患者，根据手术方式分为PFN组（n=40）和DHS组（n=36）。随访并比较两组患者受伤至手术时间、术前血红蛋白（HGB）、红细胞压积（Hct）、手术时间、术中出血量、术后引流量、术后住院天数、骨折愈合时间、住院费用以及髋关节功能Harris评分、术后并发症等指标。结果 76例患者均获得完整随访，随访时间为12～23个月，平均（17±4）个月。两组患者受伤至手术时间、手术时间、术中出血量、术后引流量、术后住院天数、骨折愈合时间、术后12个月Harris髋关节功能等级比较，差异无统计学意义（P＞0.05）；PFN组发生2例髓钉远端骨折，DHS组术后出现髋内翻1例，两组差异无统计学意义。PFN组患者的住院费用[（3.2±0.6）万元]高于DHS组[（2.2±0.4）元]，差异有统计学意义（t=4.471，P＜0.05）。结论 PFN和DHS两种内固定术式治疗股骨转子间骨折各有优、缺点和适应证，应用DHS治疗老年稳定性股骨转子间骨折是一个可行的选择，手术操作简单，价格低廉，且可获得满意的内固定效果。
Abstract:
Objective To compare the clinical effectiveness of proximal femoral nail (proximal femoral nail PFN) and dynamic hip screw (dynamic hip screw, DHS) in the treatment of stable proximal intertrochanteric fractures in the elderly. Methods A retrospective analysis was performed in 76 cases treated in Sichuan Provincial People’s Hospital from May 2010 to May 2014. They were divided into PFN treatment group (n=40) and DHS treatment group (n=36). Time to surgery, preoperative HGB and Hct, operation time, intraoperative blood loss, postoperative drainage, hospitalization time, fracture healing, costs of hospitalization, Hip function Harris score and postoperative complications were compared between two groups. Results All 76 patients were followed up for 12 to 23 months with an average of 17±4 months. Time to surgery, preoperative HGB, Hct had no significant difference between two groups; same as the operation time, intraoperative blood loss, postoperative drainage, hospitalization time, fracture healing. Two cases in PFN group had distal refracture, one case in DHS group was sent back to operation room for hip varus, complication rate between two groups had no significant difference (P>0.05). The costs of hospitalization in PFN group (3.2±0.6 wanyuan) was higher than DHS group (2.2±0.4 wanyuan), difference was statistically significant (t=4.471, P<0.05). Conclusion Both PFN and DHS have advantages and disadvantages and indications vary from these treatments. However, DHS is an effective treatment for the elderly stable intertrochanteric fractures with simple learning curve, lower cost and satisfactory internal fixation.

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备注/Memo

备注/Memo:
基金项目：四川省卫计委重点学科科研课题（H30305031130P）
更新日期/Last Update: 2017-09-15