股骨近端锁定钢板与股骨近端防旋髓内钉(PFNA)治疗AO A3型老年股骨粗隆间骨折的疗效  

Efficacy of proximal femoral locking plate and proximal femoral nail anti-Rotation(PFNA) in treatment of type AO A3 intertrochanteric fractures in elderly patients

作　　者：罗建民[1] 吕金柱[1] 朱求亮[1] 

机构地区：[1]浙江省安吉县人民医院骨科,浙江安吉313300

出　　处：《中国现代医生》2016年第18期69-72,共4页China Modern Doctor

基　　金：浙江省科技计划项目(2015C33263)

摘　　要：目的分析股骨近端锁定钢板与股骨近端防旋髓内钉（PFNA）治疗AOA3型老年股骨粗隆间骨折的疗效。方法选取本院2015年1月～2016年1月收治的AOA3型老年股骨粗隆间骨折患者48例，按照随机数字表法分为对照组和观察组，每组24例。对照组患者给予股骨近端锁定钢板进行治疗；观察组患者则采用股骨近端防旋髓内钉（PFNA）治疗，对比两组患者的治疗效果。结果观察组患者的切口长度（6．78±1．32）cm、术中出血量（217．94±23．39）mL、手术时间（60．03±2．46）min及术后负重时间（15．15±3．26）d明显优于对照组的切口长度（12．13±2．54）em、术中出血量（321．35±24．25）mL、手术时间（78．13±2．87）min及术后负重时间（22．68±3．85）d，差异有统计学意义（P〈0．05）；观察组患者术后并发症总发生率（4．17％）明显低于对照组（25．00％），且术后2个月髋关节优良率（91．67％）明显高于对照组（66．67％），差异具有统计学意义（P〈0．05）。结论股骨近端防旋髓内钉（PFNA）治疗更有利于AOA3型老年股骨粗隆间骨折患者的治疗，手术时间短，切口较小，促进了骨折痊愈，减少了术后的并发症，效果较好。Objective To analyze the efficacy of proximal femoral locking plate and proximal femoral nail anti-rotation （PFNA） in treatment of type AO A3 intertrochanteric fractures in elderly patients. Methods 48 elderly patients with type AO A3 intertrochanteric fractures treated in our hospital from Jan 2015 to Jan 2016 were selected and divided into control group （n=24） and observation group （n=24） according to numeration table. Patients in control group were given proximal femoral locking plate, while patients in observation group were treated with proximal femoral nail anti-rotation （PFNA）. The therapeutic effects were compared between two groups. Results The length of incision （6.78±1.32） cm, in- traoperative blood loss（217.94±23.39） mL, duration of operation（60.03±2.46） min, and time of weigh bearing after opera- tion（15.15±3.26） d in observation group were significantly better than those （12.13±2.54） cm, （321.35±24.25） mL, （78.13±2.87） min, and （22.68±3.85） d in control group（P〈O.05）. The overall incidence of postoperative complications in observation group（4.17%） was significantly lower than that in control group（25.00%）, and the excellent and good rate in observation group（91.67%） was significantly higher than that of the control group（66.67%）, the difference was significant （P〈0.05）. Conclusion Proximal femoral nail anti-rotation（PFNA） was more beneficial in treatment of senile patients with type AO A3 intertrochanteric fractures, with shorter time of operation, smaller incision, better recovery of fracture, fewer complications after operation, and better effect.

关 键 词：股骨近端 锁定钢板 防旋髓内钉 AO A3型老年股骨粗隆间骨折 

分 类 号：R687.3[医药卫生—骨科学]