老年股骨粗隆间骨折PFNA固定与人工股骨头置换手术治疗的比较  

Comparison of PFNA and Hemiarthroplasty of Hip in Treatment of Femoral Intertrochanteric Fracture in Elderly Patients

作　　者：何立江[1] 林其仁[1] 叶晖[1] 黄隆[1] 

机构地区：[1]福建医科大学附属第二医院骨科,福建省泉州市362000

出　　处：《中国骨与关节损伤杂志》2009年第12期1068-1070,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的分析比较PFNA固定与人工股骨头置换治疗老年股骨粗隆间骨折的临床疗效。方法自2006年3月～2008年9月,对119例老年股骨粗隆间骨折患者分别采用PFNA固定62例和人工股骨头置换治疗57例,分析比较手术持续时间、术中出血量、术后并发症发生情况和术后髋关节活动功能恢复程度。结果①PFNA组手术时间30～95min,平均(52.34±13.81)min;人工股骨头置换组70～135min,平均(91.49±15.12)min,两组间比较有显著差异,P<0.05。②PFNA组术中出血100～300ml,平均(142±45)ml;人工股骨头置换组200～500ml,平均(319±74)ml,两组间比较有显著差异,P<0.05。③术后并发症发生率两组之间差别无统计学意义,P>0.05。④术后髋关节功能改良Harris评分下降情况,两组间无统计学意义,P>0.05。结论PFNA固定与人工股骨头置换治疗老年股骨粗隆间骨折,均可获得满意的临床疗效。与人工股骨头置换手术比较,PFNA固定具有手术时间短、术中出血量少的优点。Objective To compare the clinic curative effects between the proximal femoral nail anti-rotation （PFNA） and hemiarthroplasty of hip in treatment of femoral intertrochanteric fracture in elderly patients. Methods From March 2006 to September 2008,119 cases of femoral intertrochanteric fracture in elderly patients were treated by PFNA （62 cases） and hemiarthroplasty （57 cases）. The difference between these two methods, including operation time, intraoperative bleeding, postoperative complications and the function changes of hip joint was analyzed.Results （1）The PFNA reduced the operation time compared with the hemiarthroplasty of hip, from 30-95 min with an average of （52.34±13.81） min to 70-135 min with an average of （91.49±15.12） min,P〈0.05.（2）The intraoperative bleeding was less in the cases using PFNA than those using the hemiarthroplasty of hip, from 100-300 ml with an average of （142±45） ml to 200-500 ml with an average of （319±74） ml,P〉0.05.（3）Statistical significance was revealed by no difference of postoperative complications, （P〉0.05）.（4） The decrease of the modified Harris hip score between these two operative had no significant difference （P〉0.05）.Conelusion Both the PFNA method and the hemiarthroplasty have good clinic curative effects in treatment of femoral intertrochanteric fracture in elderly patients. The former has advantages on the reduction of operation time and bleeding.

关 键 词：PFNA 半髋置换 老年 股骨粗隆间骨折 

分 类 号：R683.42[医药卫生—骨科学] R683.420.5[医药卫生—外科学]