自体植骨联合加长型防旋股骨近端髓内钉微创固定治疗股骨中上段骨折的临床效果  

Clinical effect of autogenous bone graft combined with lengthened proximal femoral nail antirotation minimal invasive inner fixation treating proximal femur fracture

作　　者：周伟[1] 黄松[1] 陈敬有[1] 孙文晓[1] 童昌军[1] 魏优秀[1] 

机构地区：[1]华中科技大学同济医学院附属梨园医院骨外科,武汉430077

出　　处：《中国医药》2016年第11期1680-1683,共4页China Medicine

基　　金：湖北省自然科学基金（2014CFB1l99）

摘　　要：目的分析自体植骨联合加长型防旋股骨近端髓内钉（PFNA）微创固定治疗股骨中上段骨折的治疗效果。方法选取2014年1—12月华中科技大学同济医学院附属梨园医院骨科收治的股骨中上段骨折患者168例，完全随机分为观察组和对照组，各84例。观察组施以自体骨移植联合加长型PFNA微创固定治疗，对照组施以自体骨移植联合动力髓螺钉治疗，观察比较2组术后1年治疗显效率、患者认可度、术后并发症发生率和恢复期长短。结果术后1年观察组治疗显效率、患者认可度均明显高于对照组[90．5％（76／84）比52．4％（44／84）、88．1％（74／84）比53．6％（45／84）]，并发症发生率低于、术后恢复期短于对照组[9．5％（8／84）比29．8％（25／84）、（58±10）d1：L（74±10）d]（均P〈0．05）。结论PFNA具有损伤小、术后恢复快且并发症少等优点；加长型PFNA微创固定治疗股骨中上段骨折效果明显、患者认可度高。Objective To analyze the clinical effect of autogenous bone graft combined with lengthened proximal femoral nail antirotation （PFNA） minimal invasive inner fixation in the treatment of proximal femur fracture. Methods Totally 168 cases of proximal femur fracture from January to December 2014 in Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology were randomly divided into observation group and control group, with 84 cases in each group. The observation group had autogenous bone graft combined with lengthened PFNA minimal invasive inner fixation; the control group had autogenous bone graft combined with dynamic hip screw fixation. One year after operation, effective rate, patient satisfaction rate, incidence of postoperative complications and length of recovery period were analyzed. Results In observation group, effective rate and patient satisfaction rate were significantly higher than those in control group [ 90. 5% （76/84） vs 52.4% （44/84）, 88.1% （74/84） vs 53.6% （45/84） ] （P 〈 0. 05） ; the incidence of postoperative complications and length of recovery period were significantly less than that in control group [ 9. 5% （8/84） vs 29.8% （25/84）, （58 ± 10） d vs （74 ± 10） d ] （ P 〈 0. 05 ）. Conclusions PFNA shows advantages of minor injury, short recovery period and few complications. Lengthened PFNA minimal invasive inner fixation is safe and effective in the treatment of proximal femur fracture.

关 键 词：骨折 加长型防旋股骨近端髓内钉 自体骨移植 

分 类 号：R683[医药卫生—骨科学]