PFNA与InterTAN钉在高龄股骨粗隆区骨折治疗中的疗效对比  

Comparison of Therapeutic Efficacy between Proximal Femoral Nail Antirotation and Intertrochanteric Antegrade Nail in the Treatment of Intertrochanteric Fractures in the Elderly

作　　者：魏龙雨 徐祝军[1] 周茂生[1] 方超[1] 黄超[1] 

机构地区：[1]皖南医学院弋矶山医院创伤骨科,安徽芜湖241001

出　　处：《沈阳医学院学报》2016年第6期440-444,共5页Journal of Shenyang Medical College

摘　　要：目的：比较股骨近端防旋髓内钉（PFNA）与股骨近端髓内钉InterTAN治疗高龄股骨粗隆区骨折的临床疗效。方法：回顾性分析我科2014年9月至2016年5月接受这两种内固定方式治疗的高龄粗隆区骨折患者，共62例，其中PFNA组28例，InterTAN组34例。对比分析这2组患者手术时间、术中出血量、住院时间及术后骨折愈合时间、术后并发症、髋关节评分。结果：PFNA组患者手术时间及术中出血量明显少于InterTAN组（P＜0.05）。2组患者住院时间、骨折愈合时间及术后10个月Harris髋关节评分差异无统计学意义。术后59例患者获得随访，随访时间9~16月，平均11.5个月。其中PFNA组随访27例，失访1例，死于慢性肾功能不全，余获得骨性愈合，其中1例出现髋关节内翻；Harris髋关节评分，优18例，良6例，可2例，差1例。InterTAN组随访32例，失访2例；随访患者中1例出现骨折不愈合，予以髋关节置换后痊愈；Harris髋关节评分，优21，良7例，可3例，差1例。2组数据对比差异无统计学意义。结论：PFNA和InterTAN在治疗高龄股骨粗隆区骨折上都具有良好的效果，但PFNA组在手术时间及术中出血量方面较InterTAN组具有更加明显的优势。Objective：To compare the effectiveness of proximal femoral nail antirotation （PFNA） with intertrochanteric antegrade nail （InterTAN） in the treatment of intertrochanteric fractures in the elderly. Methods：A retrospective study of 62 elderly patients with intertrochanteric fractures who received two operation methods from Sep 2014 to May 2016 was done. There were 28 patients in PFNA group, and 34 patients in InterTAN group. The operation time, blood loss in operation, hospitalization time, healing time, and Harris hip joint functional score were compared and analyzed. Results：Operation time and the amount of intraoperative blood loss in PFNA group were less than that in InterTAN group. Hospitalization time,fracture healing time and Harris hip joint functional score after ten months had no significant difference between the two groups. And 59 cases in total were followed up with an average of 11.5 months （from 9 to 16 months） . In PFNA group, 27 patients were followed up, and one patient was lost to follow up, who died because of chronic renal insufficiency. The rest 26 patients all achieved bony union （including one case of hip versus） . At follow-up 9 months, hip joint function was excellent in 18 cases, good in 6, fair in 2, bad in 1, and the excellent-good rate was 88.9%. In InterTAN group,32 patients were followed up,and two cases were lost to follow up. In followed-up cases, there was one patient who was no healing of fracture. After hip arthroplasty, this patient got recovery. The hip joint function was excellent in 21 cases, good in 7, fair in 3, and bad in 1. The differences between the two groups were not statisticaly significant. Conclusion：Both PFNA and InterTAN can treat intertrochanteric fractures in the elderly with good result,but PFNA has obvious advantages over InterTAN on less hemorrhage and operation time.

关 键 词：股骨粗隆区骨折 高龄 PFNA INTERTAN 

分 类 号：R687[医药卫生—骨科学]