【作者】 赵丁；

【导师】 谷贵山；

【作者基本信息】 吉林大学 ， 临床医学， 2009， 硕士

【摘要】 比较股骨近端髓内钉与动力髋螺钉这两种内固定方法治疗不稳定股骨粗隆间骨折的疗效。对2001年10月至2009年2月在我院因不稳定股骨粗隆间骨折行髓内、髓外固定术的患者共66例进行回顾性病例统计。通过来院复查、电话等方式对30例患者进行术后随访,随访内容包括患肢功能、疼痛评分等内容。并对所得到的术前、术中及术后数据进行统计学分析。股骨近端髓内钉与动力髋螺钉相比,术中失血量较少、切口长度较小(P<0.05),输血量、输血人数、手术时间、术后并发症、骨折愈合时间、术后1年内死亡人数、术前术后功能评分差无显著差异。1、股骨近端髓内钉与动力髋螺钉都是目前治疗不稳定股骨粗隆间骨折的有效内固定器械。2、股骨近端髓内钉与动力髋螺钉相比,手术损伤较小。3、股骨近端髓内钉是骨科医生治疗不稳定股骨粗隆间骨折的最佳选择之一。更多还原

【Abstract】 Objective:To compare the significance of Proximal femoral nail (PFN) and dynamic hip screw (DHS) which are both used for the fixation of unstable intertrochanteric fractures.Methods: 39 patients who underwent PFN were retrospectively compared with 27 patients who underwent dynamic hip screw (DHS) fixation in the orthopaedic department of 1st hospital Jilin university from October 2001 to February 2009. The data of each group were collected for statistically analysis on the following aspects: age, sex, type of fractures,energy factor of injury, ASA score, anesthesia type, length of incision, blood loss,blood transfusion, operative time, postoperative drainage, systemic complication, local complication, length of hospitalization, mortality, consolidation and subtraction between preoperative and postoperative Merle D’Aubigne score. The statistical analysis was performed using SPSS13.0 (statistics package for social science) software. For approximately normally distributed variables, the arithmetic mean±standard deviation and the independent sample Student’s test were used. For abnormally distributed variables, the median was used for evaluation whereas the Mann-Whitney U test was used for comparison between groups. X2 test was used for comparison between the constitution of two groups.Differences were considered to be significant at a level of P<0.05.Results: The general characteristics of the two groups, including age, type of fractures, energy factor of injury and ASA score were similar except sex. The constitution of anesthesia type in two groups is significantly different (P<0.05), the number of general anesthesia is more in PFN group than that in DHS group. The blood loss duing operation in PFN group was less than that in DHS group (P<0.05). The length of incision in PFN group was shorter than that in DHS group(P<0.05). Blood transfusion, operative time, postoperative drainage, systemic complication, local complication, length of hospitalization, mortality, consolidation, and subtraction between preoperative and postoperative Merle D’Aubigne score were not significantly different.Conclusions: 1.Both of PFN and DHS are useful instruments to supply effective internal fixation for unstable intertrochanteric fractures. 2.PFN offers several advantages over DHS in shorter incision and less blood loss. 3.PFN is one of the optimal choices for orthopaedic surgen in treating unstable intertrochanteric fracture.更多还原