PFNA-Ⅱ与PFLCP治疗高龄不稳定型股骨粗隆间骨折的效果  

Study of PFNA-Ⅱ and PFLCP in the treatment of unstable femoral intertrochanteric fracture in the elderly

作　　者：赵春成 刘勇[1] 高浩[1] 李文龙[1] 陈长春[1] 兰天亮[1] 邵川强[1] 魏星 

机构地区：[1]陕西省宝鸡市中心医院骨科,陕西宝鸡721008 [2]西安市红会医院创伤骨科,陕西西安710054

出　　处：《中国医药导报》2016年第21期107-110,共4页China Medical Herald

摘　　要：目的探讨股骨近端抗旋转髓内钉（PFNA-Ⅱ）与股骨近端解剖锁定钢板（PFLCP）治疗高龄不稳定型股骨粗隆间骨折的效果。方法回顾性分析2012年6月～2013年12月宝鸡市中心医院97例高龄不稳定型股骨粗隆间骨折患者的临床资料，其中50例患者采用PFNA-Ⅱ内固定（PFNA-Ⅱ固定组），47例患者采用PFLCP内固定（PFLCP固定组）。比较分析两组患者的手术时间、术中出血量、术后下地负重时间、骨折愈合时间、术后1年髋关节功能评分（Harris评分）及相关并发症发生情况等。结果97例患者均顺利完成手术，随访时间6～15个月，平均（10．23±4．26）个月。PFNA-Ⅱ固定组在手术时间（f=24．88，P〈0．01）、术中失血量（t=77．72，P〈0．01）、术后下地时间（t=14．73，P〈0．01）及相关并发症（x2=4．44，P〈0．05）方面均优于PFLCP固定组，而在骨折愈合时间（t=1．82，P〉0．05）及术后Harris评分优良率（x2=1．15，P〉0．05）方面差异无统计学意义。结论PFNA-Ⅱ具有操作简单、创伤小、骨折固定牢靠、符合生物学固定原则、并发症少及患者可早期离床负重等优点，是治疗股骨粗隆间骨折的理想方法，尤其适合高龄不稳定型患者。Objective To discuss the clinical efficacy of proximal femoral anti-rotation nail （PFNA-Ⅱ ） and proximal femoral locking compress plate （PFLCP） in the treatment of unstable femoral intertrochanteric fracture in the elderly. Methods From June 2012 to December 2013, clinical data of 97 elderly patients with unstable femoral intertrochanter- ic fracture in the Central Hospital of Baoji City were retrospectively analyzed, there were 50 cases in PFNA-Ⅱ internal fixation （PFNA-Ⅱgroup）, while 47 cases in PFLCP internal fixation （PFLCP group）. Operation time, intraoperative blood loss, time of postoperation weight loading, fracture healing time, Harris hip scores one year after operation and related complications were comparatively analyzed. Results All patients were operated successfully, and were followed up for 6-15 months, with average （10.23＋4.26） months. Compared with PFNA-Ⅱ group, the operative time （t = 24.88, P 〈 0.01）, intraoperative blood loss （t = 77.72, P 〈 0.01）, time of postoperation weight loading （t = 14.73, P 〈 0.01） and related complication （X2 = 4.44, P 〈 0.05） were better than those of the PFLCP group, however, there was no significant difference in healing time （t = 1.82, P 〉 0.05） and Harris hip score （x2 = 1.15, P 〉 0.05） between two groups. Conclu- sion PFNA-Ⅱfixation of intertrochanteric fracture has the advantages of simple operation, limited invasion, in accor- dance with the principle of biological fixation, stable fixation, less complications, and patients can get out of bed early weight-bearing, which is especially suitable for elderly patients.

关 键 词：股骨粗隆间骨折 股骨近端抗旋髓内钉 股骨近端解剖锁定钢板 内固定 

分 类 号：R683.41[医药卫生—骨科学]