PFN治疗股骨粗隆间骨折的临床效果及其对术后功能恢复的影响  

Clinical effect of proximal femoral nail in the treatment of intertrochanteric fracture of femur and the effect of postoperative functional recovery

作　　者：张铁成[1] 许多红 张伟伟[3] 朱琳[1] 王宝兰[1] 

机构地区：[1]新疆医科大学第一附属医院康复医学科,乌鲁木齐830054 [2]乌鲁木齐市中医医院骨科,乌鲁木齐830001 [3]新疆军区总医院皮肤科,乌鲁木齐830000

出　　处：《中国医学前沿杂志（电子版）》2017年第11期46-49,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：新疆维吾尔自治区自然科学基金项目(2014211C042)

摘　　要：目的探讨股骨近端带锁髓内钉(proximal femoral nail,PFN)治疗股骨粗隆间骨折的临床效果及对患者术后功能恢复的影响。方法将2013年1月至2016年1月新疆医科大学第一附属医院收治的81例股骨粗隆间骨折患者按照随机数表法分为髓内钉组(43例)和锁定钢板组(38例)。髓内钉组患者采用PFN治疗,锁定钢板组患者采用锁定钢板内固定治疗。比较两组患者手术治疗效果及膝关节功能的差异。结果髓内钉组患者手术时间和骨折愈合时间均显著短于锁定钢板组(P<0.05),术中出血量和术后引流量均显著少于锁定钢板组(P<0.05)。两组患者住院天数无显著差异(P>0.05),髓内钉组患者术后膝关节功能优良率显著高于锁定钢板组(P<0.05)。术后6个月,两组患者疼痛、行走能力、关节稳定性、伸膝关节、膝关节活动度及Rasmussen膝关节功能总分均无显著差异(P>0.05)。结论与锁定钢板内固定相比,PFN治疗股骨粗隆间骨折的效果更好,患者创伤小、恢复快,膝关节功能恢复较好。m ObjectiveTo investigate clinical effect of proximal femoral nail （PFN） in the treatment of intertrochanteric fracture of femur and the effect of postoperative functional recovery. Method81 patients with intertrochanteric fracture of femur were randomly divided into intramedullary nail group （n = 43） and locking steel plate group （n = 38） according to the random number table from January 2013 to January 2010 in the First Afiliated Hospital of Xinjiang Medical University. Intramedullary nail group patients were treated with PFN, locking steel plate group patients were treated with locking plate fixation. The surgical effect and knee function differences between the two groups were compared. ResultThe operation time and fracture healing time of intramedullary nail group were significantly shorter than those of locking steel plate group （P 〈 0.05）, the intraoperative amount of bleeding and postoperative volume of drainage were significantly less than those of locking steel plate group （P 〈 0.05）, there was no significant difference in the length of stay between the two groups （P 〉 0.05）. The excellent and good rate of knee joint function in intramedullary nail group was higher than that in locking steel plate group （P〈0.05）. 6 months after operation, there were no significant differences in the pain, walking ability, joint stability, knee extension, knee joint activity and Rasmussen knee function score between the two groups （P 〉 0.05）. ConclusionCompared with locking plate fixation, PFN has a good effect in the treatment of intertrochanteric fracture of femur, the trauma is small, fast recovery, knee function recovery is also better.

关 键 词：股骨近端带锁髓内钉 股骨粗隆间骨折 膝关节功能 

分 类 号：R687.3[医药卫生—骨科学]