DHS\解剖型锁定钢板及PFN内固定治疗股骨粗隆间骨折疗效研究(1)
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【摘要】 目的 探讨动力髋螺针(Dynamic hip screw pin, DHS)、解剖型锁定钢板及股骨近端髓内钉(proximal femoral nail, PFN)内固定治疗股骨粗隆间骨折疗效差别。方法 将2005年6月至2008年8月就诊于我科的股骨粗隆间骨折患者78例分为3组，分别给予DHS、解剖型锁定钢板及PFN内固定法治疗，分别观察其治疗效果。结果 DHS组、解剖型锁定钢板组及PFN组的优良率依次为79.16%、88.46%及85.71%，各组间差异无统计学意义。解剖型锁定钢板组及PFN组的手术时间及术中失血量少于DHS组。结论 三种治疗方法为治疗股骨粗隆间骨折的有效方法，但其在降低手术时间及减少术中失血方面，解剖型锁定钢板及PFN优于DHS。
【关键词】 动力髋螺针；解剖型锁定钢板；股骨近端髓内钉；股骨粗隆间骨折
A Comparison Study of DHS, Anatomic Locking Plate and PFN Treatment on Femoral Intertrochanteric Fracture
WANG Chen. Department of Orthopedics, Second Affiliated Hospital,Shandong University of TCM, Jinan 250001,China
【Abstract】 Objective
To study the DHS, anatomic locking plate and PFN treatment on femoral intertrochanteric fracture. Methods Between June 2005 and August 2008, 78 patients with osteoporotic femoral intertrochanteric fracture were divided into three groups, undergoing DHS, anatomic locking plate and PFN treatment respectively. The operative time, blood loss and operation complications were compared among there groups. Results The eligible rates of DHS, anatomic locking plate and PFN were 79.16%,88.46% and 85.71%, and there were no significant difference among them. There were significantly short operative time, less blood loss in anatomic locking plate and PFN group than in DHS groups (P<0.05). There was no significant difference between anatomic locking plate and PFN groups for them. Conclusion Three treatment methods are the effective methods for intertrochanteric fractures. However, the anatomic locking plate and the PFN are better than DHS in reducing operation time and reduce blood loss.
【Key words】
DHS; Anatomic Locking Plate; PFN; Femoral Intertrochanteric Fracture
作者单位：250001山东中医药大学第二附属医院骨科
股骨粗隆间骨折是骨外科常见病之一，随着人口老龄化及交通事故的增加，加之股骨粗隆部位特殊的解剖特点，使股骨粗隆间骨折的发生率进一步增加。在治疗上保守治疗效果不明显，因此，切开复位内固定是其治疗的标准方案[1,2]。为比较不同内固定方法的治疗效果，2005年6月至2008年8月应用DHS、解剖型锁定钢板及PFN内固定方法治疗股骨粗隆间骨折78例，现总结报告如下。
1 资料与方法
1.1 一般资料 选取2005年6月至2008年8月就诊于我科的符合入选标准的股骨粗隆间骨折患者78例。致伤原因：摔伤36例，车祸28例，坠落伤6例，其他8例。EvansJensen 分型：Ⅰ型 4例，Ⅱ型 12 例，Ⅲ型 46例，Ⅳ型10例，Ⅴ型 6 例。根据患者病情及意愿将其分为DHS、解剖型锁定钢板及PFN内固定3组，DHS组24例，男10例，女14例；年龄为30～85岁，平均62.5岁。解剖型锁定钢板组26例，男13例，女13例；年龄为28～87岁 ......
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