Clinical study of two methods of internal fixation for intertrochanteric fractures

doi:10.3877/cma.j.issn.1674-134X.2019.05.018

Abstract

Abstract:

Objective

To explore the clinical efficacy and analyse the complications of proximal femoral nail antirotation(PFNA) and dynamic hip screw(DHS) in the internal fixation for intertrochanteric fractures of femur.

Methods

Sixty cases of intertrochanteric fracture of femur were included in this study. They were all treated in the Affiliated Hospital of Southern Universtiy of Science and Technology from January 2017 to January 2019. They were divided randomly into DHS group (n=30) and PFNA group (n=30) according to random number table method. Both groups were given routine preoperative preparation and postoperative treatment, DHS group were treated with DHS internal fixation, PFNA group were treated with PFNA internal fixation. The discharged patients were followed up for half a year. The difference of surgical indicators between the two groups, and the complications of the two groups were compared. Half a year after discharge, the fracture healing indicators and the Harris scores were also compared. Chi-square test and t test were used for analysis.

Results

The operation time, bleeding volume and incision length of PFNA group were shorter than or less than those of DHS group (t=3.029, 9.416, 8.945, all P<0.01). Half a year after discharge, the fracture healing time and weight-bearing time of PFNA group were shorter than those of DHS group (t=2.118, 3.227, both P<0.05). The total Harris scores of PFNA group and DHS group were higher than those of DHS group half a year after discharge, and PFNA group were higher than that of DHS group, the difference was statistically significant (t=2.485, P<0.05). Postoperative complications were both 10% in PFNA group and DHS group.

Conclusions

PFNA and DHS can treat intertrochanteric fractures of femur. PFNA internal fixation has obvious advantages over DHS, which shows shorter operation time, less bleeding, less trauma, higher healing rate and higher Harris score and improves the limb function.

Key words: Hip fractures, Fracture fixation, intramedullary, Bone screws

Xinjie Wu, Zhifeng Li, Xin Wei. Clinical study of two methods of internal fixation for intertrochanteric fractures[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2019, 13(05): 619-624.

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References 18

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分组	例数	性别(男/女)	年龄[年，(±s)]	病程[h,(±s)]	受伤机制[例(%)]			Evans骨折分型(例)		并发症(例)
分组	例数	性别(男/女)	年龄[年，(±s)]	病程[h,(±s)]	跌倒	交通事故	其他	Ⅰ型	Ⅱ型	高血压病	糖尿病	心脑血管疾病
DHS组	30	15/15	69±3	25±3	15(50)	9(30)	6(20)	15	15	6	6	12
PFNA组	30	18/12	67±4	28±3	15(50)	6(20)	9(30)	18	12	9	9	12
统计值	?	F＝9.56	t＝42.7	t＝18.6	F＝3.53			F＝5.27		F＝2.48
P值	?	>0.05	>0.05	>0.05	>0.05			>0.05		>0.05

分组	例数	性别(男/女)	年龄[年，(±s)]	病程[h,(±s)]	受伤机制[例(%)]			Evans骨折分型(例)		并发症(例)
分组	例数	性别(男/女)	年龄[年，(±s)]	病程[h,(±s)]	跌倒	交通事故	其他	Ⅰ型	Ⅱ型	高血压病	糖尿病	心脑血管疾病
DHS组	30	15/15	69±3	25±3	15(50)	9(30)	6(20)	15	15	6	6	12
PFNA组	30	18/12	67±4	28±3	15(50)	6(20)	9(30)	18	12	9	9	12
统计值	?	F＝9.56	t＝42.7	t＝18.6	F＝3.53			F＝5.27		F＝2.48
P值	?	>0.05	>0.05	>0.05	>0.05			>0.05		>0.05

组别	例数	手术时间(min)	出血量(ml)	切口长度(cm)
PFNA组	30	45.0±5.2	101.3±10.3	6.1±0.8
DHS组	30	57.2±5.4	158.3±16.2	9.8±1.8
t值	?	3.029	9.416	8.945
P值	?	<0.01	<0.01	<0.01

组别	例数	手术时间(min)	出血量(ml)	切口长度(cm)
PFNA组	30	45.0±5.2	101.3±10.3	6.1±0.8
DHS组	30	57.2±5.4	158.3±16.2	9.8±1.8
t值	?	3.029	9.416	8.945
P值	?	<0.01	<0.01	<0.01

组别	例数	骨折愈合时间	负重时间
PFNA组	30	6.1±1.0	11.5±1.3
DHS组	30	7.3±1.4	14.6±1.5
t值	?	2.188	2.327
P值	?	<0.05	<0.05

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