微创医学

【摘要】目的比较动力髋螺钉(DHS)、股骨近端防旋髓内钉(PFNA)及股骨近端加压锁定钢板(PFLCP)治疗股骨粗隆间骨折的临床疗效。方法选取股骨粗隆间骨折患者95例，根据病情分别采用DHS（31例）、PFNA（34例）、PFLCP（30例）三种内固定术式治疗，比较三组的临床疗效。结果DHS、PFLCP组住院时间、手术时间、术中出血量、负重时间及并发症比较，差异均有统计学意义(P＜0.05)；而PFNA组上述指标分别与其余两组比较，明显优于DHS、PFLCP组，差异有统计学意义(P＜0.05)。结论PFNA以创伤小、出血少、术后负重时间早、并发症少等优点，尤其适用于内侧皮质不连续的不稳定型股骨粗隆间骨折，包括逆粗隆间骨折，值得推广应用。

【Abstract】 ObjectiveTo compare the clinical efficacy among dynamic hip screw ( DHS ), proximal femoral nail antirotation ( PFNA ) and proximal femoral locking compression plate ( PFLCP ) in the treatment of femoral intertrochanteric fracture. MethodsNinetyfive patients with femoral intertrochanteric fracture were enrolled and received internal fixation using DHS（n=31）, PFNA（n=34）or PFLCP（n=30）according to patients′ condition. The clinical efficay was compared among the three groups. ResultsThere were significant differences in the hospital stay, operative duration, blood loss, duration for weightbearing walking and incidence of complications between the two groups(P＜0.05). The indices above in the PFNA group were significantly superior to those in DHS group and PFLCP group (P＜0.05). ConclusionPFNA has the advantages of less trauma, less blood loss, early weightbearing walking after operation and less complications, thereby it is specially suitable for the unstable intertrochanteric fracture with discontinuous medial cortex, including the reverse oblique intertrochanteric fracture. this approach is worthy of promotion and application.

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