DHS And PFNA Comparison For The Treatment Of Femoral Fractures Between Rotor

Objective:through to the usual screening of medical records to make statistical analysis,comparison of dynamic hip screw(DHS)and the spin proximal femoral nail antirotation(PFNA)the clinical curative effect of treatment of senile femoral fracture between the rotor,and discuss the advantages and disadvantages of two kinds of operation method.Methods:the development of the reference for the treatment of femoral fractures between rotor in recent years related literature,selection conforms to the second affiliated hospital of dalian medical university in March 2010 to July 2010 among 82 patients with fracture of femur rotor between respectively using DHS and PFNA treatment were analyzed retrospectively,all patients were treated for 10 days after injury adept,operation are all the same surgeon,multiple trauma patients,patients with femoral fracture,the fracture involving the rotor is not included in this study.All patients were followed up for 12～18 months,an average of 15.6 months.Divided into dynamic hip screw(DHS)and the spin in femoral nail antirotation group(PFNA),easy to record respectively for the control group(n = 40)group(n = 42).Compare two groups of patients in the operation time,intraoperative blood loss,length of incision,postoperative flow rate,length of hospital stay,postoperative complications and Harris hip score differences.Results:the average operation time was 73.4 +/-3.6 min,less than the control group of 84.5 +/-4.1 min.In respect of intraoperative blood loss,the experimental group was 273.8 +/-6.4 ml,while the control group was 357.2 +/-357.2 ml,better than the control group.Incision length of experimental group was 5.8 +/-0.9 cm,and the control group was 10.6 +/-2.2 cm.the average length of incision due to the control group.Finally led traffic and length of hospital stay after surgery in experimental group is obviously better than the control group.All statistics difference was statistically significant(p<0.05).For the average postoperative fracture healing time(the experimental group was 15.8 +/-1.4 w.the control group was 16.7 +/-1.6 w)differences of complication rates no statistical difference(p>0.05).According to the Tronzo-Evans points,according to the Ⅰ～Ⅲ,the function of Harris hip score difference no statistical significance(p>0.05),and for type Ⅳ and Ⅴ,experiments show better than the control way and Ming,Harris hip score difference was statistically significant(p<0.05).Conclusion:DHS and PFNA can be applied to various types of rotor between femur fractures.A large number of literature about who has a lot of research has better therapeutic effect for there is no definite answer.Here I first point out that,after all,the operation is artificial operation,the instrument effect difference also often because of operational problems and the difference is not obvious and even the opposite happens,this will require surgery operator preoperative careful observation of fracture image information,the patient of fracture site,quantity,type,have a good understanding,to develop a detailed plan before hand,intraoperative to have skilled solution and operation process,careful management of key operation,operation on careful attention to aseptic consciousness second DHS compared with PFNA in clinical application of time grew a lot.and the application of PFNA relatively short time,can lead to a lot of doctors to the operation of the DHS operation lessons to heart,and for PFNA operation is in a stage of cognition and learning,to operate along,nature also can affect the effect.But after all DHS.as a representative of the pulp external fixation of the classic applications for a long time,but it still and external fixation for treatment need to shed a lot of soft tissue,increases the degree of trauma surgery,in promoting the minimally invasive treatment today,seems to become inappropriate,but the curative effect of fracture between DHS for most of the rotor should be put forward definitely.As the representative of the new generation technology of intramedullary PFNA has simple operation,and the advantages of small trauma,accord with biomechanics,has gradually become a mainstream way for the treatment of fractures between rotor.Here,on the selection of treatment,can according to the patients’ condition and proficiency in the doctor’s flexible selection of DHS and PFNA to treat femoral fracture between rotor stability,instability for rotor between fractures,should choose PFNA treatment.