不同内固定方法治疗老年股骨粗隆间骨折的病例对照研究

目的比较分析动力髋螺钉（DHS）和防旋股骨近端髓内钉内固定（PFNA）、Gamma钉内固定三种不同内固定方法治疗股骨粗隆间骨折的疗效。方法选择2009年1月～2012年1月在大庆油田总医院的96例股骨粗隆间骨折患者,采取1∶1的病例对照的研究方法随机分为A组（PFNA内固定术）、B组（DHS内固定术）、C组（Gamma钉内固定术）,各32例,应用统计学方法对比分析三组患者的各项手术观察指标情况。结果与B、C组比较,A组手术用时最短,术中出血量最少,术后并发症发生率最低（P〈0.05）,C组的手术时间、术中出血量明显少于B组,术后并发症也明显低于B组（P〈0.05）,三组髋关节Haris评分优良率比较,差异无统计学意义（P〉0.05）,但A组的优良率最高,达90.6%。结论 PFNA内固定具有手术时间短、骨折临床愈合时间短、并发症发生率低的优点,值得广泛推广和应用。

Case-control study of the different internal fixation treatment of intertrochanteric fracture

Objective To compare and analyze the dynamic hip screw（dynamichipscrew DHS） and the anti-rotation of proximal femoral intramedullary nail（proximalfemornalnailantirotation,PFNA） fixed Gamma nail fixation for treatment of intertrochanteric fractures.Methods 96 cases of intertrochanteric fracture patients in Daqing Oilfield General Hospital from January 2009 to January 2012,taking 1：1 case-control study were selected randomly divided into group A（PFNA fixation） and group B（DHS fixation）,group C（Gamma nail fixation）,32 cases for each group,and the operative time,blood loss,fracture healing the time Harris score,and complications were observed and compared.Results Compared with group B and group C,group A were the shortest time,at least blood loss and the lowest incidence of postoperative complications（P 0.05）,operative time,blood loss of the C group was significantly less than B group,postoperative complications was significantly lower than that in group B（P 0.05）,compared three groups of hip Haris rated excellent rate,the difference was not statistically significant,but group A had fine highest rate of 90.6%.Conclusion Compared with the DHS,Gamma nail fixation,PFNA has less surgical and less blood loss,shorter average fracture healing time,intraoperative and postoperative fewer complications,ti is more suitable for clinical widely promoted and applied.