三种不同术式治疗不稳定型转子间骨折的临床观察  

Clinical observation on three different therapeutic methods in the treatment of unstable intertrochanteric fractures

作　　者：宋继淳[1] 梁健[1] 施土河 黄宏宇 岑怡彪[1] SONG Jichun;LIANG Jian;SHI Tuhe;HUANG Hongyu;CEN Yibiao(Department of Joint Surgery,Lianjiang People's Hospital of Guangdong,Guangdong,Lianjiang 524400,China)

机构地区：[1]广东省廉江市人民医院关节外科,广东廉江524400

出　　处：《中国医药科学》2020年第8期219-222,共4页China Medicine And Pharmacy

基　　金：广东省湛江市科技计划项目(2017B01199)。

摘　　要：目的探讨三种术式治疗不稳定型转子间骨折(UIFF)的效果。方法回顾性分析2015年2月~2018年9月廉江市人民医院收治的90例UIFF患者临床资料,根据术式的不同将患者分为A组、B组和C组,每组30例。A组采用股骨近端解剖锁定钢板(ALP)治疗,B组采用股骨近端防旋髓内钉(PFNA)治疗,C组采用全髋关节置换术(THA)治疗。对比三组的手术情况、Harris评分、Barthel指数和并发症。结果B组的手术时间和术中显性出血量均明显少于A组和C组(P<0.05)。下地负重站立以C组最早,B组次之,A组最迟(P<0.05)。在术后1个月和术后6个月时,C组的Harris评分和Barthel指数均最高,B组次之,A组均最低(P<0.05)。结论THA能提前UIFF患者的下地负重站立时间、加快髋关节功能和生活质量的改善,而PFNA则具有手术时间短和术中显性出血量少的优点。Objective To investigate the effects of three different therapeutic methods in the treatment of unstable intertrochanteric fractures(UIFFs).Methods Retrospective analysis was conducted on the clinical data of 90 UIFF patients admitted and treated in Lianjiang People's Hospital from February 2015 to September 2018,and were divided into the group A,group B and group C according to different therapeutic methods,with 30 patients in each group.Group A was treated with proximal femoral anatomical locking plate(ALP),group B was treated with proximal femoral nail anti-rotation(PFNA),and group C was treated with total hip arthroplasty(THA).The surgical conditions,Harris score,Barthel index and complications were compared among the three groups.Results The operation time and apparent intraoperative bleeding volume in group B were significantly lower than those in groups A and C(P<0.05).Weight-bearing standing on the ground was primarily achieved in group C,followed by group B,and the latest in group A(P<0.05).At 1 month and 6 months after surgery,both Harris score and Barthel index were the highest in group C,followed by group B,and the lowest in group A(P<0.05).Conclusion THA can advance the time of weightbearing standing on the ground of UIFF patients,accelerate the improvement of hip joint function and quality of life,while PFNA has the advantages of short operation time and less apparent intraoperative bleeding volume.

关 键 词：不稳定型转子间骨折 全髋关节置换术 股骨近端防旋髓内钉 股骨近端解剖锁定钢板 

分 类 号：R687.3[医药卫生—骨科学]