Shen Guangyin
Department of Orthopedics, Dongfang Hospital of Yangzhou, Yangzhou Jiangsu, 225000, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Jun;26(6):671-4.
To compare the effectiveness of the proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of elderly patients with intertrochanteric fractures.
Between May 2007 and May 2010, 63 elderly patients with intertrochanteric fractures were treated, and fractures were fixed with PFNA in 31 patients (PFNA group) and with DHS in 32 patients (DHS group). There was no significant difference in gender, age, injury cause, disease duration, and fracture type between 2 groups (P > 0.05).
All incisions healed by first intention. The incision length, operation time, and blood loss in PFNA group were significantly less than those in DHS group (P < 0.05). The average follow-up time was 13.6 months in PFNA group and was 13.8 months in DHS group. The fracture healing time was (11.80 +/- 1.32) weeks in PFNA group and was (12.21 +/- 1.26) weeks in DHS group, showing no significant difference (t=1.23, P=0.29). The complication rate was 0 in PFNA group and was 12.5% (4/32) in DHS group, showing no significant difference (P=0.06). After 1 year, Harris hip score of PFNA group (86.55 +/- 10.32) was higher than that of DHS group (80.36 +/- 11.18) (t=2.28, P=0.03).
There are two surgical methods to treat intertrochanteric fractures in the elderly patient: PFNA and DHS, and each has advantages; for unstable intertrochanteric fractures, PFNA treatment is the first choice.
比较股骨近端抗旋髓内钉（PFNA）与动力髋螺钉（DHS）治疗老年股骨转子间骨折的疗效。
2007年5月至2010年5月，收治63例老年股骨转子间骨折患者，其中31例采用PFNA固定（PFNA组），32例采用DHS固定（DHS组）。两组患者在性别、年龄、致伤原因、病程及骨折类型方面差异无统计学意义（P>0.05）。
所有切口均一期愈合。PFNA组切口长度、手术时间及失血量均明显少于DHS组（P<0.05）。PFNA组平均随访时间为13.6个月，DHS组为13.8个月。PFNA组骨折愈合时间为（11.80±1.32）周，DHS组为（12.21±1.26）周，差异无统计学意义（t=1.23，P=0.29）。PFNA组并发症发生率为0，DHS组为12.5%（4/32），差异无统计学意义（P=0.06）。1年后，PFNA组Harris髋关节评分（86.55±10.32）高于DHS组（80.36±11.18）（t=2.28，P=0.03）。
治疗老年股骨转子间骨折有PFNA和DHS两种手术方法，各有优势；对于不稳定型股骨转子间骨折，首选PFNA治疗。
