[1]侯建伟,谢仁国,李玉前,等.加长型 PFNA-Ⅱ和DHS治疗老年骨质疏松性股骨转子下骨折的疗效分析[J].中华老年骨科与康复电子杂志,2017,(01):22-26.[doi:10.3877/cma.j.issn.2096-0263.2017.01.005]
　Hou Jianwei,Xie Renguo,Li Yuqian,et al.Clinical effective analysis of lengthened PFNA- II fixation and dynamic hip screw for senile osteoporotic subtrochanteric fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):22-26.[doi:10.3877/cma.j.issn.2096-0263.2017.01.005]
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加长型 PFNA-Ⅱ和DHS治疗老年骨质疏松性股骨转子下骨折的疗效分析()
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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01期
页码:
22-26
栏目:
股骨骨折
出版日期:
2017-02-05

文章信息/Info

Title:
Clinical effective analysis of lengthened PFNA- II fixation and dynamic hip screw for senile osteoporotic subtrochanteric fractures
作者:
侯建伟 1; 谢仁国 2; 李玉前 1; 王晓东 1; 李宏斌 1; 张建华 1
226000 江苏南通大学附属南通第三人民医院骨科 1；200086 上海市第一人民医院创伤中心 2
Author(s):
Hou Jianwei;  Xie Renguo;  Li Yuqian;  Wang Xiaodong;  Li Hongbin;  Zhang Jianhua
Department of Orthopedics, Affiliated Third Hospital of Nantong University, Nantong 226000, China; Trauma Center, Shanghai General Hospital, Shanghai 200080, China
关键词:
髋骨折;  骨质疏松症;  老年人;  内固定器;  股骨近端防旋髓内钉
Keywords:
Hipfractures;  Osteoporosis;  Aged;  Internalfixators;  Proximalfemoralnailanti-rotation
DOI:
10.3877/cma.j.issn.2096-0263.2017.01.005
文献标志码:
A
摘要:
目的 探讨加长型股骨近端防旋髓内钉-II （PFNA-II）内固定和动力髋螺钉（DHS）治疗老年骨质疏松性股骨转子下骨折的临床疗效。方法 回顾性分析 2010年 8月至 2015年 3月江苏南通大学附属南通第三人民医院骨科收治的老年骨质疏松性股骨转子下骨折患者共 48例，根据手术方式不同分为加长型 PFNA-Ⅱ组（n=24）与 DHS组（n=24）。比较两种手术方法的手术时间、术中出血量、骨折愈合时间及 Harris髋关节评分。结果 加长型 PFNA-II组随访时间 12～45个月，平均（20.6±1.8）个月；DHS 组随访时间 12～30个月，平均（19.2±2.1）个月。加长型 PFNA-Ⅱ组手术时间（[ 50.2±9.6）min]少于 DHS 组（[ 80.6±15.8）min]、术中出血量（[ 120.6±17.1）ml]少于DHS组（[ 358.2±42.5）ml]、骨折愈合时间（[ 18.7±6.6） w]少于 DHS组（[ 23.9±10.3）w]，差异均具有统计学意义（t=8.056，t=25.409，t=2.082，P＜0.05）。末次随访时 Harris 评分，加长型 PFNA-II 组（[ 84.2±8.9）分]高于 DHS 组（[ 79.1±6.5）分]，差异具有统计学意义（t=2.267，P＜0.05）。结论 采用加长型 PFNA-II治疗老年骨质疏松性股骨转子下骨折具有手术时间短，创伤小，骨折固定牢靠，术中、术后并发症较低等优点，是一种可选择的较为理想的内固定方法。
Abstract:
Objective To evaluate the clinical effectiveness of lengthened proximal femoral nail anti- rotation - II (PFNA- II) and dynamic hip screw (DHS) in the treatment of senile osteoporotic subtrochanteric fractures. Methods A retrospective review was conducted in 48 elderly patients with osteoporotic subtrochanteric fractures treated in Affiliated Third Hospital of Nantong University from August 2010 to March 2015. Patients were divided into lengthened PFNA-II (n=24) group and DHS group (n=24) according to different fixators. Time of operation, intraoperative blood loss, fracture healing time and Harris hip joint function scale of two groups were documented and compared. Results Patients in PFNA-II group were followed up for 12- 45 months with an average of (20.6 ± 1.8) months. Patients in DHS group were followed up for 12-30 months with an average of (19.2±2.1) months. The operation time of PFNA-II group were (50.2±9.6) min, which was shorter than the DHS group（[ 80.6 ±15.8）min]. Blood loss of PFNA-II group were (120.6±17.1) ml and healing time were (18.7±6.6) weeks, both were lower than the DHS group（[ 358.2± 42.5）ml],[ （23.9±10.3）w], differences were statistically significant (t=8.056, t=25.409, t=2.082, P<0.05). At the last follow- up, Harris hip joint function score of lengthened PFNA- II group (84.2 ± 8.9) was significantly higher than the DHS group (79.1±6.5),difference was statistically significant (t=2.267, P<0.05). Conclusions The lengthened PFNA-II group present shorter operation time, less injury and solid fixation, it is an alternative method for senile osteoporotic subtrochanteric fracture.

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备注/Memo

备注/Memo:
基金项目：江苏省临床医学科技专项基金（BL2013020）
更新日期/Last Update: 2017-04-01