两种内固定方法治疗股骨转子下骨折的疗效  

Comparison effect of two treatment methods for treatment of femoral subtrochanteric fractures

作　　者：杨洪军[1] YANG Hong-jun(Dept of Orthopaedics,the People′s Hospital of Yaan City,Yaan,Sichuan 625000,China)

机构地区：[1]雅安市人民医院骨科,四川雅安625000

出　　处：《临床骨科杂志》2018年第5期599-601,共3页Journal of Clinical Orthopaedics

摘　　要：目的观察股骨近端防旋髓内钉(PFNA)与股骨近端解剖锁定钢板(PFLCP)治疗股骨转子下骨折的临床疗效。方法对76例股骨转子下骨折患者分别采用PFNA(PFNA组,40例)和PFLCP(PFLCP组,36例)内固定治疗。比较两组患者的切口长度、手术时间、术中出血量、功能锻炼时间、骨折愈合时间以及功能评价情况。结果 76例患者均获得随访,时间12～24个月。PFNA组:切口长度(7. 9±2. 7) cm,手术时间(67. 2±13. 3) min,术中出血量(126. 2±53. 2) ml,功能锻炼时间(2. 6±2. 3)周,骨折愈合时间(10. 2±2. 7)周; PFLCP组:切口长度(10. 6±2. 2) cm,手术时间(105. 2±11. 3) min,术中出血量(183. 3±46. 5) ml,功能锻炼时间(6. 9±2. 5)周,骨折愈合时间(12. 8±3. 5)周;以上各项指标PFNA组均短(少)于PFLCP组,差异均有统计学意义(P <0. 05)。末次随访时,采用髋关节Harris评分评价疗效:PFNA组优良率为97. 5%,PFLCP组优良率为83. 3%,差异有统计学意义(P <0. 05)。术后并发症发生率:PFNA组为7. 5%,PFLCP组为16. 7%,差异有统计学意义(P <0. 05)。结论 PFNA治疗股骨转子下骨折操作简单,固定可靠,并发症少,效果显著,是治疗股骨转子下骨折的有效方法。Objective To observe the clinical effect of proximal femoral nail antirotation （PFNA） and proximal femoral locking compression plate （PFLCP） for treatment of femoral subtrochanteric fractures. Methods The 76 patients with femoral intertrochanteric fractures who had been treated by PFNA （PFNA group,40 cases） or PFLCP （PFLCP group,36 cases） were carried out. These data were compared between two groups, including length of incisions, operation time, volume of intraoperative bleeding, exercise time, fracture healing time and function evaluation. Results The 76 cases were followed up,the time ranged from 12 months to 24 months. By using PFNA fixation, the length of incisions was （7.9±2.7）cm, the operation time was （67.2±13.3） min,interaoperative blood loss was （126.2± 53.2） ml, the exercise time was （2.6±2.3）weeks,the fracture healing time was （10.2±2.7） weeks. By using PFLCP fixation, the length of incisions was （10.6±2.2） cm, the operation time was （105.2±11.3） min,interaoperative blood loss was （183.3±46.5） ml, the exercise time was （6.9±2.5） weeks,the fracture healing time was （12.8±3.5） weeks. The above various indexes of PFNA group were shorter （less） than those in PFLCP group, there were significant differences between two groups （P 〈0.05）.According to Harris scale, the excellent-good rate in PFNA group （97.5%） was higher than that in PFLCP group （83.3%）,the difference had statistical significance （ P 〈0.05）.The incidence rate of postoperative complications： PFNA group was 7.5%, PFLCP group was 16.7%, the difference had statistical significance （ P 〈0.05）. Conclusions PFNA is an effective method in the treament of femoral subtrochanteric fractures, because PFNA is simple, reliable fixation, which has fewer complications,better effect.

关 键 词：股骨转子下骨折 股骨近端防旋髓内钉 股骨近端解剖锁定钢板 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]