股骨近端防旋髓内钉与股骨近端锁定钢板治疗老年股骨粗隆间骨折的对比研究  

Contrast between the Curative Effect of Proximal Femoral Nail Antirotation and Locking Proximal Femoral Plate for Femoral Intertrochanteric Fracture in Senile Patients

作　　者：毛显法 朱利军[1] 宋晓燕[1] 李红[1] 杨林[1] 代守志[1] 赵霖[1] 秦谊[1] 方跃[2] 

机构地区：[1]成都市温江区人民医院骨科,成都611130 [2]四川大学华西医院骨科

出　　处：《华西医学》2015年第7期1209-1212,共4页West China Medical Journal

摘　　要：目的比较股骨近端防旋髓内钉（PFNA）与股骨近端锁定钢板（LPFP）治疗老年股骨粗隆间骨折的临床效果。方法回顾性分析2008年10月-2014年3月收治的116例老年股骨粗隆间骨折患者资料，其中60例应用PFNA治疗，56例应用LPFP治疗。分别从手术时间、手术出血、手术并发症、下床锻炼时间、骨折愈合情况及关节功能恢复情况进行比较。结果115例患者得到随访，时间12—24个月，平均15．7个月，1例患者死亡，PFNA组与LPFP组手术时间分别为（83．26±14．81）、（102．58±15．31）min，术中出血量分别为（202．16±33．14）、（255．80±45．92）mL，下地锻炼时间分别为（1．80±0．91）、（3．48±3．03）周，骨折愈合时间分别为（11．80±2．26）、（12．14±2．21）周，术后髋关节Harris评分为（84．56±9．55）、（82．47±9．22）分，两组在手术时间、术中出血量及下地行走时间方面差异有统计学意义（P〈0．05），在骨折愈合时间及术后髋关节Harri评分方面差异无统计学意义（P〉0．05）。结论PFNA及LPFP均是治疗老年患者股骨粗隆间骨折的有效方法，但应用PFNA手术时间更短，术中出血量更少，术后下地行走时间更早。Objective To compare the clinical effect of proximal femoral nail antirotation （PFNA） and locking proximal femoral plate （LPFP） for femoral intertrochanteric fracture in elderly patients. Methods We respectively analyzed the clinical data of 116 senile patients with femoral intertrochanteric fracture treated between October 2008 and March 2014. Among them, 60 were treated with PFNA, and 56 were treated with LPFP. We compared the two groups of patients in terms of operating time, surgical blood loss, surgical complications, walking exercise time, fracture healing time and joint function recovery. Results A total of 115 patients had regular follow-up from 12 to 24 months （averaging 15.7 months）. One patient died. The operating time was （83.26±14.81） minutes in PFNA group and （102.58±15.31） minutes in LPFP group. The surgical blood loss was （202.16±33.14） mL in PFNA group and （255.80±45.92） mL in LPFP group. The walking exercise time was （1.80±0.91） weeks in PFNA group and （3.48±3.03） weeks in LPFP group.The fracture healing time was （11.80±2.26） weeks in PFNA group and （12.14±2.21） weeks in LPFP group. The postoperative Harris score for hip joint was 84.56±9.55 in PFNA group and 82.47±9.22 in LPFP group. There were statistical differences in operating time, surgical blood loss and walking exercise time （P 〈 0.05）, while no statistical differences were found in fracture healing time and postoperative Harris score for hip joint （P 〉 0.05）. Conclusion PFNA and LPFP are effective methods for femoral intertrochanteric fracture in elderly people, but PFNA has a shorter operating time, less surgical blood loss and earlier walking exercise time.

关 键 词：股骨近端防旋髓内钉 股骨近端锁定钢板 老年 股骨粗隆间骨折 

分 类 号：R687.3[医药卫生—骨科学]