人工关节置换及PFNA用于老年股骨粗隆间骨折的临床疗效比较  

Clinical efficacy comparison of artificial joint replacement and PFNA in the elderly femoral intertrochanteric fracture

作　　者：郭攀[1] 王丹[1] 闵继康[1] 

机构地区：[1]浙江省湖州市第一人民医院,湖州313000

出　　处：《浙江创伤外科》2017年第5期837-839,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的本研究系统性地针对人工关节置换及防旋股骨近端髓内钉内固定术(PFNA)分别应用于老年股骨粗隆间骨折治疗的临床疗效进行评价,旨在对该疾病的临床手术治疗提供一定参考依据。方法对本院收治的老年股骨粗隆骨折患者82例,按手术治疗方式分成PFNA和人工关节置换两组,分别比较其手术时间、术中出血量、下地负重时间及术后6周复查Harris髋关节评分。结果手术时间PFNA组明显短于人工关节置换组,术中出血量PFNA组明显少于人工关节置换组,但在下地负重时间这一项,人工关节置换组明显早于PFNA组;两组术后6周复查Harris髋关节评分,PFNA组优12例、良13例、一般14例、差2例、优良率60.98%,而人工关节置换组优18例、良16例、一般3例、差4例、优良率78.05%。结论 PFNA组在手术时间、术中出血量这两项指标上明显优于人工关节置换组,髋关节置换在卧床时间及下地负重时间等方面具有绝对的优势。Objective To study the clinical effect of artificial joint replacement and PFNA in the treatment of elderly femoral in-tertrochanteric fracture. Methods 82 cases of femoral intertrochanteric fracture in our hospital were divided into PFNA group and artificial joint replacement group. The operation time,intraoperative blood loss,the time of fields and Harris hip score after 6 weeks were compared. Results the operation time of PFNA group was shorter than that of the artificial joint substitution groups group,the intraoperative blood lossof PFNA group was significantly less than that of the artificial joint. But the lower loading timeof the artificial joint substitution group was earlier than that of the PFNA group. The Harris hip score was revised 6 weeks after operation. In the PFNA group excellent 12,good 13,general 14,poor 2,good rate was 60.98%.In the artificial joint replacement group excellent 18,good 16,general 3,poor 4,good rate was 78.05%. Conclusion the PFNA group is superior to the artificial joint substitution groups in operation time and blood loss,hip replacement has an absolute advantage in bed time and ground loading time.

关 键 词：防旋股骨近端髓内钉内固定术 人工髋关节置换术 手术时间 术中出血量 下地负重时间 

分 类 号：R687.3[医药卫生—骨科学]