PFNA和ALP治疗老年股骨转子间骨折的疗效对比研究  

Comparison of Efficacy of Proximal Femoral Nail Antirotation and Anatomic Proximal Femoral Locking Plate in the Treatment of Intertrochanteric Fractures

作　　者：郭义超[1] 彭阿钦[2] 周晓哲[3] 刘勇[3] 

机构地区：[1]保定市骨科医院,071000 [2]河北医科大学附属第三医院,石家庄050000 [3]河北大学附属医院,保定071000

出　　处：《医学研究杂志》2017年第8期188-190,共3页Journal of Medical Research

摘　　要：目的比较股骨近端防旋转髓内钉(proximal femoral nail antirotation PFNA)和股骨近端解剖型锁定钢板(anatomic proximal femoral locking plate ALP)治疗老年股骨转子间骨折的疗效。方法收集2011年1月~2014年1月于笔者医院行PFNA和ALP手术并得到完整随访的病例42例,PFNA组22例,ALP组20例,按AO/OTA分型。记录两组患者手术时间、手术切口长度、术中失血量、术后患肢负重时间、术后并发症、骨折愈合时间和术后3个月Harris髋关节功能评分,进行统计学处理。结果两组病例年龄、性别、骨折类型及Singh指数比较,差异无统计学意义(P>0.05),有可比性。两组患者手术时间、切口长度、术中出血量、患肢负重时间、骨折愈合时间比较,差异均有统计学意义(P<0.05)。术后3个月两组患者Harris评分优良率比较,差异有统计学意义(P<0.05)。PFNA和ALP组术后并发症髋内翻和内固定松动的发生率比较,差异有统计学意义(P<0.05),其他术后并发症发生率比较,差异无统计学意义(P>0.05),两组术后并发症总发生率比较,差异有统计学意义(P<0.05)。结论PFNA与ALP比较具有创伤小、手术时间短、术中出血少,且操作简单、固定可靠,能使患者早期下地负重及功能锻炼;PFNA治疗股骨转子间骨折疗效好于ALP,便于基层开展。Objective To compare the clinical results of intertrochanteric fractures using proximal femoral nail antirotation （PFNA） and anatomic proximal femoral locking plate（ ALP）. Methods A review study was conducted in 42 patients who were treated by means of PFNA and ALP and followed up from January 2011 to January 2014. According to the AO/OTA classification,22 cases were treated with PFNA and 20 eases with ALP. We evaluated their operation time, incision length, intra - operative bleeding, post - operative weight bearing - time, post - operative complications, healing time of fracture and the ADL scores 3 months after the operation. Results There were significant differences between the two groups in comparison of sex, age, fracture type,and Singh Index（P 〉 0.05）. Big differerces between the two groups can be seen in comparison of their operation time, incision length, intra - operative bleeding, weight bearing - time, healing time of fracture （P 〈 O. 05 ）. 3 months after the operations, we can see the differences between the 2 groups in comparison of Harris scores. The comparison of post - operative complications ： there are differences between the PFNA and ALP groups in hip varus and internal fixation, still in the general complications （ P 〈 0. 05 ） , but no differences in comparison of the related complications. Conclusion In comparison, PFNA has the advantages such as shorter incision length,shorter operative time, less blood loss, more sim- ple operation, more reliable fixation,and earlier weight beating. PFNA is superior to ALP in treating intertrochanteric fractures, which can be applied conveniently to the grassroots.

关 键 词：髓内钉 锁定钢板 股骨 转子间 骨折 

分 类 号：R683.42[医药卫生—骨科学]