| 摘要: |
| ［摘要］ 目的 探讨老年股骨粗隆间骨折患者采取三种内固定方式［（股骨近端防旋髓内钉（proximal femoral nail antirotation,PFNA）、股骨近端锁定板（locking paoximal femoral plate,LPFP）、动力髋螺钉（dynamic hip screw,DHS）］治疗的临床效果。方法 选择该院2012-01～2015-10收治的老年股骨粗隆间骨折患者128例作为研究对象，根据治疗方式不同分为三组，其中PFNA组44例采取PFNA治疗，LPFP组42例采取LPFP治疗，DHS组42例采取DHS治疗。观察记录三组术中与术后指标变化，以及随访1年时Harris髋关节功能评定效果，并对比分析。结果 与LPFP组和DHS组比较，PFNA组手术时间较短，术中出血量较少，负重时间、住院时间、骨折愈合时间较短，并发症发生率较低（P<0.05）；LPFP组住院时间较DHS组短（P<0.05）；三组随访1年髋关节功能优良率比较差异无统计学意义（P>0.05）。结论 PFNA、LPFP、DHS治疗老年股骨粗隆间骨折均有较好效果，但PFNA最佳，LPFP次之，DHS最差，临床应合理选择。 |
| 关键词: 老年股骨粗隆间骨折 内固定 股骨近端防旋髓内钉 股骨近端锁定板 动力髋螺钉 |
| DOI：10.3969/j.issn.1674-3806.2017.11.17 |
| 分类号:R 68 |
| 基金项目: |
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| Comparison of the clinical effects among three internal fixation methods in the treatment of intertrochanteric fractures in the elderly |
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LI Yan-wen
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Department of Orthopedics, the People ′s Hospital of Shanglin County, Guangxi 530500, China
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| Abstract: |
| ［Abstract］ Objective To investigate the clinical effects of three kinds of internal fixation methods in the elderly patients with intertrochanteric fractures.Methods A total of 128 elderly patients with intertrochanteric fractures were selected in our hospital from January 2012 to October 2015. They were divided into three groups according to the different treatment methods. Of the 128 patients, 44 cases were treated with proximal femoral nail antirotation(PFNA)(PFNA group), other 42 cases were treated with locking paoximal femoral plate(LPFP)(LPFP group), and the rest 42 cases were treated with dynamic hip screw(DHS)(DHS group). The operative and postoperative indexes, and the scores of Harris hip function at 1 year of the follow-up were compared among the three groups.Results The time of operation, bleeding, weight loading, hospitalization and fracture healing were significantly shorter and the incidence of complications was significantly lower in the PFNA group than those in the LPFP group and DHS group(P<0.05). The hospitalization time of LPFP group was shorter than that of the DHS group(P<0.05). There were no significant differences in the excellent rates of hip function among the three groups at 1 year of the follow-up(P>0.05).Conclusion PFNA, LPFP and DHS are all effective in the treatment of intertrochanteric fractures in the elderly. However, PFNA has the best clinical effect, followed by LPFP and DHS. |
| Key words: Elderly femoral intertrochanteric fractures Internal fixation Proximal femoral nail antirotation(PFNA) Locking paoximal femoral plate(LPFP) Dynamic hip screw(DHS) |
