2种内固定方式治疗股骨干骨折合并同侧髋部骨折的疗效分析  

A comparative analysis of 2 internal fixation methods for ipsilateral fractures of hip and femoral

作　　者：郭瑛[1] 黄智[1] 彭波[1] 云雄[1] 李伟[1] 杨建明[1] 

机构地区：[1]解放军第187中心医院骨一科,海南海口571159

出　　处：《局解手术学杂志》2014年第4期378-380,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的比较股骨近端防旋髓内钉(PFNA)与股骨近端解剖锁定板(ALCP)治疗股骨干骨折合并同侧髋部骨折的疗效。方法回顾性分析2009年1月至2012年6月采用PFNA和ALCP治疗的26例股骨干合并同侧髋部骨折患者临床资料,其中PFNA组14例,ALCP组12例。对2组手术时间、术中失血量、骨折愈合时间、并发症及髋膝关节功能等进行比较。结果与ALCP组相比,PFNA组在缩短手术时间及减少术中失血优势明显,差异有统计学意义(P<0.05)。26例均获1年以上随访,平均25个月。2组患者均无切口感染、深静脉血栓形成、肺栓塞、内固定断裂、股骨头缺血性坏死及肢体严重旋转与短缩畸形等并发症。2组各部位骨折愈合时间比较,差异无统计学意义(P>0.05)。骨折完全愈合后,2组髋关节Harris评分和膝关节Evanich评分比较,差异无统计学意义(P>0.05)。结论 PFNA与ALCP均为固定股骨干合并同侧髋部骨折的良好内固定物,但PFNA在减少手术创伤、缩短手术时间方面更具优势。Objective To compare the effectiveness of proximal femoral nail antirotation （PFNA） and anatomic locking compression plate（ALCP） for ipsilateral fractures of hip and femoral. Methods Clinical data of 26 cases of ipsilateral fractures of hip and femoral from January 2009 to June 2012 were retrospectively analyzed. 14 eases of them were fixed by proximal femoral nail antirotation while 12 cases were fixed with anatomic loking compression plate. The operation time, blood loss, fracture healing time, complications, and hip knee joint function were compared between the 2 groups to evaluate the effectiveness. Results The operation time and blood loss in the PFNA group were significantly less than those in the ALCP group （ P 〈 0.05 ）. All patients were followed up at least one year （ meanly 25 months）. There were no complications such as wound infection, deep venous thrombosis, pulmonary embolism, breakage of the implants, avascular necrosis of the femoral head, or serious rotation and shortening deformity of lower limbs. There was no significant difference in fracture healing time, Harris hip score, and Evanich knee score between the 2 groups （ P 〉 0.05 ）. Conclusion Both PFNA and ALCP are good material to treat ipsilateral fractures of hip and femoral, but PFNA is superior in simplifing operation.

关 键 词：股骨 髋部 骨折 内固定 微创 

分 类 号：R683.42[医药卫生—骨科学]