不同内固定方式治疗股骨近端良性骨肿瘤伴病理性骨折的疗效对比  

The comparison of curative effect of different internal fixation methods for the treatment of benign bone tumors of the proximal femur with pathological fractures

作　　者：郎志刚 方向[1] 吴凡 刘宏远[1] 段宏 LANG Zhi-gang;FANG Xiang;WU Fan;LIU Hong-yuan;DUAN Hong(Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Osteopathy,Sichuan Provincial Orthopedic Hospital,Chengdu 610041,China)

机构地区：[1]四川大学华西医院骨科,四川成都610041 [2]四川省骨科医院骨病科,四川成都610041

出　　处：《实用医院临床杂志》2019年第2期213-216,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析不同内固定方式治疗股骨近端良性骨肿瘤伴病理性骨折的疗效。方法 98例股骨近端良性骨肿瘤伴病理性骨折患者,根据不同内固定方式分为三组:锁定解剖钢板(LCP)组28例,动力髋螺钉(DHS)组32例,股骨近端防旋髓内钉(PFNA)组38例。比较三组一般手术情况、治疗效果、并发症及功能情况。结果 LCP组及DHS组手术时间和术中出血量低于PFNA组;负重时间和骨折愈合时间高于PFNA组(P <0. 05); PFNA组并发症发生率低于LCP组及DHS组(P <0. 05)。结论 DHS和LCP内固定方式在缩短手术时间和减少术中出血量方面优于PFNA,而PFNA内固定方式使患者能早期下地负重,促进骨折愈合,减少并发症。Objective To compare the curative effects of different internal fixation methods for the treatment of benign bone tumors of the proximal femur with pathological fractures.Methods Ninety-eight patients with benign bone tumors of the proximal femur with pathological fractures were divided into locking anatomical plate(LCP)group(=28),dynamic hip screw(DHS)group(n=32)and the proximal femur anti-rotation intramedullary nail(PFNA)group(n=38)according to different internal fixation methods.The general operating conditions,therapeutic effects,complications and functional status of the three groups were compared.Results The operation time and intraoperative blood loss in the LCP group and the DHS group were shorter or lower than those in the PFNA group(P<0.05).The weight bearing time and fracture healing time of the PFNA group were significantly shorter than those of the LCP and the DHS group(P<0.05).The complication rate of the PFNA group was lower than that of the LCP group and the DHS group(P<0.05).There was no significant difference in the MSTS scores of the three groups after 1 year of surgery.Conclusion The method of DHS and LCP is superior to PFNA in shortening operation time and reducing intraoperative blood loss.However,the method of PFNA internal fixation could make patients to bear weight at an early stage,promote the fracture healing and reduce the complications.

关 键 词：股骨近端 良性骨肿瘤 病理性骨折 内固定 

分 类 号：R683.42[医药卫生—骨科学]