PFNA-Ⅱ术式240mm主钉和170mm主钉治疗股骨转子间骨折患者的疗效对比研究  

A comparative study of 240 mm and 170 mm nails in the treatment of intertrochanteric fractures of femur treated with PFNA-Ⅱ

作　　者：葛兴涛[1] 杨金虎[1] 赵涛[2] GE Xing-tao;YANG Jin-hu;ZHAO Tao(Department of Orthopaedics,People s Hospital of Rizhao,Rizhao,Shandong 276826,China;Department of Anesthesiology,People s Hospital of Rizhao,Rizhao,Shandong 276826,China)

机构地区：[1]日照市人民医院骨科,山东日照276826 [2]日照市人民医院麻醉科,山东日照276826

出　　处：《创伤外科杂志》2020年第5期383-386,共4页Journal of Traumatic Surgery

基　　金：济南医学院教师科研扶持基金(JYFC2018FKJ087)。

摘　　要：目的比较亚洲型股骨近端防旋髓内钉(PFNA-Ⅱ)术式240mm主钉和170mm主钉治疗股骨转子间骨折患者的效果。方法回顾性分析2016年1月-2018年5月日照市人民医院骨科收治的140例股骨转子间骨折患者的临床资料。根据选择主钉长度的不同,将患者分为240mm组(n=75,选择240mm主钉进行PFNA-Ⅱ术式治疗)和170mm组(n=65,选择170mm主钉进行PFNA-Ⅱ术式治疗)。240 mm组中男性40例,女性35例;年龄49~79岁,平均69.2岁。170mm组男性34例,女性31例;年龄50~82岁,平均69.8岁。比较两组患者的围手术期指标和股骨前皮质主钉抵触率;随访6个月,记录患者术后VAS评分和Harris髋关节功能评分;比较两组患者术后并发症发生情况。结果170mm组患者的手术时间和住院时间分别为(52.5±9.3)min、(8.1±1.6)d,均短于240mm组的(68.5±12.6)min、(9.9±1.4)d,术中失血量和股骨前皮质主钉抵触率分别为(119.2±26.1)m L和8%,均低于240mm组的(158.6±23.7)m L和37%,差异均有统计学意义(P<0.05)。两组患者术后1、3、6个月的VAS评分和Harris髋关节功能评分比较,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论PFNA-Ⅱ术式240mm主钉和170mm主钉治疗股骨转子间骨折患者的疗效及安全性相当,但选择170mm主钉具有操作简便、创伤小、术后恢复快、更吻合股骨前弓形态的优势。Objective To compare the effect of Asian type proximal femoral anti-rotation intramedullary nail(PFNA-Ⅱ)with 240 mm main nail and 170 mm main nail in the treatment of intertrochanteric fracture of femur.Methods The data of 140 patients with intertrochanteric fracture of femur from Jan.2016 to May 2018 were analyzed retrospectively,who were divided into 240 mm group(n=75,240 mm main nail was selected for PFNA-Ⅱoperation)and 170 mm group(n=65,170 mm main nail was selected for PFNA-Ⅱoperation)according to the different length of main nail.There were 40 males and 35 females in the 240 mm group,with an average age of 69.2 years(range from 49 to 79 years).There were 34 males and 31 females in the 170mm group,with an average age of 69.8 years(range from 50 to 82 years).The indexes of perioperative period and the resistance rate of main nail in the anterior cortex of femur were compared between the two groups.The patients were followed up for 6 months,and the visual analogue score(VAS)and Harris hip function score were recorded.The postoperative complications of the two groups were compared.Results The operation time and hospitalization time of 170 mm group were(52.5±9.3)min,(8.1±1.6)d,respectively,which were shorter than(68.5±12.6)min and(9.9±1.4)d in 240 mm group;the blood loss and the resistance rate of main nail in the anterior cortex of femur were(119.2±26.1)mL and 8%,respectively,which were lower than(158.6±23.7)mL and 37%in 240 mm group,and the differences were statistically significant(P<0.05).There was no significant difference in VAS score and Harris hip function score between the two groups at 1,3 and 6 months after operation(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The efficacy and safety of 240 mm main nail PFNA-Ⅱfor the treatment of intertrochanteric fracture of femur is similar to that of 170 mm main nail.However,170 mm main nail has the advantages of simpler operation,less trauma,quicker recovery after operation a

关 键 词：股骨转子间骨折 髓内钉 主钉长度 疗效 

分 类 号：R683.42[医药卫生—骨科学]