PFNA内固定与人工股骨头置换术治疗高龄股骨粗隆间骨折疗效比较  

Clinical efficacy in comparision of proximal femoral nail anti-rotation with hemiarthroplasty in treatment of femoral intertrochanteric fractures in senile patients

作　　者：关长勇[1] 常青[1] 彭伟[1] 黄迅悟[1] 马远征[1] 

机构地区：[1]解放军第309医院全军骨科中心,北京市100091

出　　处：《中国骨与关节损伤杂志》2013年第2期110-112,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的对比分析股骨近端防旋髓内钉(PFNA)内固定与人工股骨头置换术治疗高龄骨质疏松性股骨粗隆间骨折的疗效。方法 120例高龄股骨粗隆间骨折随机分为两组:A组(54例)采用股骨粗隆间骨折专用假体行人工股骨头置换术;B组(66例)采用PFNA内固定。结果 118例获随访12～52个月,平均32.6个月。两组扶拐下地活动时间(A组平均3.8 d,B组平均4.2 d)差异无统计学意义(P>0.05);手术时间、术中失血量及术后并发症发生率差异有显著统计学意义(P<0.01)。结论对高龄骨质疏松性股骨粗隆间骨折采用PFNA内固定后创伤小、效果良好,而人工股骨头置换创伤较大,是特殊情况下的选择。Objective To compare the results and complications of hemiarthroplasty and proximal femoral nail anti-rotation （PFNA） in the treatment of femoral intertrochanteric fractures for senile patients with osteoporosis. Methods All of 120 senil patients with femoral intertrochanteric fractures were divided into two groups. Fifty four patients were treated with hemiarthroplasty（group A）, 66 patients were treated with proximal femoral nail anti-rotation internal irLxation（group B）. Results One hundred and eighteen patients were followed up for 12 to 52 months,an average of 32.6 months. There were no significant difference in ambulation time between the two groups （an average of 3.8 days in group A and average 4.2 days in group B, P 〉 0.05）. There were significant difference in operation time, the amount of biooding and comparison of complications （P 〈0.01）. Conclusion Treatment of femoral intertrochanteric fractures with PFNA internal fixation is a feasible and effective and safe way.Hemiarthroplasty for the senile patients with severe osteoporosis is an alternative.

关 键 词：股骨粗隆间骨折 人工股骨头置换术 PFNA 内固定 高龄 

分 类 号：R687.32[医药卫生—骨科学] R687.33[医药卫生—外科学]