加长型与标准型股骨近端防旋髓内钉治疗不稳定性转子间骨折的比较  

Comparison of Curative Effect of the Long Type and the Standard Type Proximal Femoral Nail Antirotation to Treat Unstable Intertrochanteric Fracture

作　　者：李明[1] 周立义[1] 李君[1] 

机构地区：[1]海南医学院附属医院骨科,海口570102

出　　处：《中国中医骨伤科杂志》2016年第4期22-25,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:分析比较加长型与标准型股骨近端防旋髓内钉(PFNA)治疗不稳定性转子间骨折的临床效果。方法:收集2009年5月至2014年5月采用加长型与标准型股骨近端防旋髓内钉治疗且获得随访的120例不稳定性转子间骨折患者的临床资料,将病例分为标准型PFNA组(S组)、加长型PFNA组(L组),记录两组患者手术时间、术中出血、住院时间及两组患者Harris评分及功能恢复情况;对骨折愈合情况、影像学情况、并发症的情况进行评估。结果:两组患者手术时间、术中出血、住院时间、骨折平均愈合时间、Harris评分差异均无统计学意义(P>0.05)。S组螺旋刀片移位、股骨远端继发性骨折的发生率明显高于L组,差异有统计学意义(P<0.05)。L组患者在总并发症率、再手术率上均优于S组患者,差异有统计学意义(P<0.05),两组患者死亡率差异无统计学意义(P>0.05)。结论:对于高龄不稳定转子间骨折的患者,加长型PFNA具有固定牢固、术后并发症少、生物力学性能好等优点,值得临床推广。Objective：To explore and compare curative effect of the long type and the standard type proximal femoral nail antirotation to treat unstable intertrochanteric fracture.Methods：120cases of unstable intertrochanteric fracture was collected in May 2009 to May 2014 in our hospital.They were treated with the the long type and the standard type PFNA and obtained more than a year of follow-up.They were divided into two groups：the long type PFNA group（group L）and the standard type PFNA group（group S）.The operation time,intraoperative mean bleeding volum,the length of time,fracture union and situation of imaging,clinical complications,Harris score and functional recovery of two group were recorded and evaluated.Results：For the operation time,intraoperative bleeding,average hospitalization time,fracture healing time,Harris score of two groups,the differences had no statistical significance（P〈0.05）.The incidence of spiral blade displacement and the secondary distal femur fractures in group S are significantly higher than that in group L.The difference was statistically significant（P〈0.05）.The total complication rate and reoperation rate of patients in group L were better than that in group S.The difference was statistically significant（P〈0.05）.The differences of the mortality between two groups have no statistical significance（P〈0.05）.Conclusion：For elderly patients with unstable intertrochanteric fracture,the long type PFNA has a lot of advantages such as more firm fixation,less postoperative complications,better biological mechanics performance.And it deserved the clinical promotion.

关 键 词：加长型PFNA 标准型PFNA 不稳定转子间骨折 股骨 

分 类 号：R683.42[医药卫生—骨科学]