股骨近端防旋髓内钉内固定治疗高龄股骨转子间骨折的疗效  

Curative effect of proximal femoral nail antirotation internal fixation in the treatment of senile intertrochanteric fracture

作　　者：陈贵彬[1] 翁阳华[1] 伊莉[1] 杨宏栋[1] CHEN Gui-bin;WENG Yang-hua;YI Li;YANG Hong-dong(Dept of Orthopaedics,Humen Hospital of Dongguan City,Dongguan,Guangdong 523900,China)

机构地区：[1]东莞市虎门医院骨科,广东东莞523900

出　　处：《临床骨科杂志》2019年第1期89-92,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨股骨近端防旋髓内钉(PFNA)内固定治疗高龄股骨转子间骨折的疗效。方法将90例高龄股骨转子间骨折患者按照治疗方式分为PFNA组(采用PFNA内固定,n=50)与动力髋螺钉(DHS)组(采用DHS内固定,n=40)。比较两组手术情况、术后下床活动时间、负重行走时间、骨折愈合时间及并发症发生率。末次随访采用Harris评分评定髋关节功能情况。结果切口长度、手术时间、术中出血量、住院时间、术后下床活动时间、术后负重时间、骨折愈合时间PFNA组均短(少)于DHS组,差异均有统计学意义(P <0. 05)。患者均获得随访,时间8～12个月。髋关节功能恢复优良率PFNA组高于DHS组,并发症发生率PFNA组低于DHS组,但差异均无统计学意义(P> 0. 05)。结论 PFNA内固定治高龄股骨转子间骨折内固定效果稳定,可促进患者髋关节功能恢复,减少术后并发症。Objective To investigate the curative effect of proximal femoral nail antirotation(PFNA)internal fixation in the treatment of senile intertrochanteric fracture.Methods The 90 elderly patients with intertrochanteric fractures were divided into PFNA group(PFNA internal fixation,n=50)and dynamic hip screw(DHS)group(DHS internal fixation,n=40)according to the treatment methods.The surgical condition,the postoperative out of bed activity time,weight-bearing walking time,fracture healing time and incidence rate of complications were compared between the two groups.The hip joint function recovery was evaluated by Harris hip function scale at the last follow-up.Results The length of incision,surgical time,intraoperative blood loss,length of hospital stay,postoperative out of bed activity time,weight-bearing time and fracture healing time of PFNA group were shorter(less)than those of DHS group,but the differences were not significiant(P<0.05).All the patients were followed up for 8~12 months.The excellent and good rate of hip joint function recovery was higher in PFNA group than that in DHS group,and the incidence rate of complications was lower than that in DHS group,while there weren′t statistical differences(P>0.05).Conclusions The fixation effect of PFNA internal fixation is stable in the treatment of senile intertrochanteric fracture.It can promote the recovery of hip function and reduce the incidence of postoperative complications.

关 键 词：股骨转子间骨折 股骨近端防旋髓内钉 动力髋螺钉 内固定 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]