【摘要】 [目的]探讨动力髋螺钉(DHS)、联合防旋阻挡钉与股骨近端髓内钉(PFN)治疗不稳定型股骨粗隆间骨折的临床效果。[方法]入选90例老年不稳定型股骨粗隆间骨折患者,随机分为DHS联合防旋阻挡钉组、PFN组和DHS组实施内固定手术。术后随访时间为12～24个月。从切口长度、手术时间、术中透视时间、术中出血量、住院时间、术后功能恢复时间及术后并发症方面比较三组的临床效果。[结果]PFN组在切口长度、术中出血量、早期负重时间、术后3个月功能恢复等方面明显优于DHS联合防旋阻挡钉组和DHS组(P<0.05),在住院时间、术后并发症等方面三组无统计学差异。[结论]PFN具有良好的生物力学稳定性,可以作为不稳定型股骨粗隆间骨折的首选内固定装置;DHS联合防旋阻挡钉重建股骨后内侧结构,也是不稳定型粗隆间骨折的良好选择;单纯DHS治疗不稳定型粗隆间骨折,失败率较高,但仍是内侧结构稳定的粗隆间骨折的标准术式。更多还原

【Abstract】 [Objective]To explore the effect of the treatment of femoral intertrochanteric fractures using the DHS combined with antirotation screw,PFN and DHS.[Method]Ninety elder patients with unstable femoral intertrochanteric fracture were randomized to be treated with a DHS combined with antirotation screw,a PFNA or a DHS,and followed up for 12-24 months,outcomes and complications of the three groups were compared.[Result]The outcomes of the group PFN were better than the other two in the length of incision,blood loss,time of mobilization with aid and walking ability 3 months after surgery(P<0.05).There were no significant differences among the three groups in hospital stay and complications.[Conclusion]PFN is the first choice for the unstable femoral intertrochanteric fracture,and the DHS combined with antirotation screw is also a useful technique.DHS is still the standard device for stable femoral intertrochanteric fracture.更多还原