股骨粗隆间骨折钢板内固定与防旋型股骨近端髓内钉治疗疗效的对比研究  

Clinical analysis of PFNA and plate internal fixation in the treatment of femoral intertrochanteric fracture

作　　者：杨文斌[1] 杨益宏[1] 刘兴国[1] 宋明辉[1] 

机构地区：[1]西安高新医院骨一科,西安710075

出　　处：《陕西医学杂志》2018年第1期78-80,共3页Shaanxi Medical Journal

摘　　要：目的:探讨钢板内固定与防旋型股骨近端髓内钉(PFNA)治疗股骨粗隆间骨折的疗效。方法:将100例股骨粗隆间骨折患者随机分为观察组和对照组,每组50例,观察组患者采用PFNA治疗,对照组采用钢板内固定治疗,比较两组的手术时间、术中出血量、住院时间、骨折愈合时间,术后6个月评价两组的髋关节功能恢复效果以及术后并发症的发生率。结果:观察组手术时间、术中出血量明显少于对照组(P<0.05);术后6个月PFNA对不稳定型骨折患者髋关节功能的优良率为89.29%,显著高于对照组的65.38%(P<0.05);而两组总疗效优良率无统计学差异(P>0.05);另外,观察组术后并发症发生率为12%,显著低于对照组的28%(P<0.05)。结论:PFNA法相比常规的钢板内固定法治疗股骨粗隆间骨折疗效更好,具有手术时间短、术中出血量低、术后并发症少的优点,尤其适合不稳定型股骨粗隆间骨折患者。Objective:To analyse the therapeutical effect of the plate internal fixation and proximal femoral intramedullary nail anti-rotation in the treatment of femoral intertrochanteric fracture.Methods:100 patients with femoral intertrochanteric fracture in our hospital were randomly divided into observation group and control group,50 cases in each group.The patients in the observation group were given PFNA internal fixation,and patients in the control group were treated with plate internal fixation.Operation time,the intraoperative blood loss,hospital stay and fracture healing time were compared between the two groups.Besides,the recovery effect of hip function and postoperative complications were evaluated in these two groups six months after surgery.Results:The operation time and the intraoperative blood loss in the observation group were significantly less than the control group(P<0.05).Besides,the fitness rate of hip function of unstable intertrochanteric femoral fracture in the observation group(89.29%)was significantly higher than those in the control group(65.38%)while there's no obvious difference in the total fitness rate between these two groups(P >0.05).Besides,the postoperative complications of the observation group(12%)was less when compared with the control group(28%)(P<0.05).Conclusion:PFNA internal fixation has the advantage of shorter operation time,less intraoperative blood loss and less postoperative complications over plate internal fixation,especially for unstable intertrochanteric femoral fracture patients.

关 键 词：股骨骨折/外科学 骨折固定术 内 ＠钢板内固定 ＠近端髓内钉 

分 类 号：R683.42[医药卫生—骨科学]