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股骨近端锁定加压钢板、股骨近端防旋髓内钉与动力髋螺钉治疗股骨转子间骨折的对比研究。

A comparative study of proximal femoral locking compress plate, proximal femoral nail antirotation and dynamic hip screw in intertrochanteric fractures.

机构信息

Department of Orthopaedics, Dongying Second People's Hospital, Dongying, China.

出版信息

Eur Rev Med Pharmacol Sci. 2018 Jul;22(1 Suppl):119-123. doi: 10.26355/eurrev_201807_15373.

Abstract

OBJECTIVE

We aimed to compare the clinical efficacy of three different internal fixation methods, i.e. proximal femoral locking compress plate (PF-LCP), proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) system in intertrochanteric femur fracture.

PATIENTS AND METHODS

We selected a total of 150 patients with Intertrochanteric femur fracture who were admitted to this hospital between January 2015 and December 2016 for treatment, and those patients were divided into three groups according to the difference in treatment methods, i.e., Group A (n=50), Group B (n=50) and Group C (n=50). For patients in Group A, they received the PF-LCP treatment, patients in Group B received PFNA treatment while those in Group C received DHS treatment; ultimately, clinical efficacy was compared among three groups.

RESULTS

In Group B, the efficacy was superior to those in Group A and C in terms of comparison of surgical duration, bleeding amount, time point of callus formation, healing time of fracture and length of stay (LOS) in hospital (p<0.05); after operation, the prevalence rate of complication in Group B was significantly lower than those in Group A and Group C (p<0.05); in comparison of preoperative Harris score among three groups, the different had no statistical significance (p>0.05). The Harris scores in Group B at the 1st, 3rd, and 6th month after operation were all significantly higher than those in Group A and C (p<0.05).

CONCLUSIONS

Compared with PF-LCP and DHS, PFDA can better fix the intertrochanteric femur fracture with little effect on blood circulation at the fracture end and slight damage to sclerotin, thereby accelerating the recovery of hip joint function without any increase in prevalence of complications. Therefore, PFDA has a promising clinical efficacy and safety, which is worthy of being promoted in clinical practice.

摘要

目的

比较股骨近端锁定加压钢板(PF-LCP)、股骨近端髓内钉抗旋(PFNA)和动力髋螺钉(DHS)系统三种内固定方法治疗股骨转子间骨折的临床疗效。

患者和方法

选取 2015 年 1 月至 2016 年 12 月我院收治的股骨转子间骨折患者 150 例,根据治疗方法的不同分为 A 组(n=50)、B 组(n=50)和 C 组(n=50)。A 组患者采用 PF-LCP 治疗,B 组患者采用 PFNA 治疗,C 组患者采用 DHS 治疗,比较三组的临床疗效。

结果

B 组手术时间、术中出血量、骨痂形成时间、骨折愈合时间、住院时间均优于 A 组和 C 组(P<0.05);术后 B 组并发症发生率明显低于 A 组和 C 组(P<0.05);三组术前 Harris 评分比较,差异无统计学意义(P>0.05);B 组术后 1、3、6 个月的 Harris 评分均明显高于 A 组和 C 组(P<0.05)。

结论

与 PF-LCP 和 DHS 相比,PFNA 治疗股骨转子间骨折可更好地固定骨折端,对骨折端血液循环影响小,对骨质破坏小,可加快髋关节功能恢复,且并发症发生率无增加,具有较好的临床疗效和安全性,值得在临床推广应用。

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