InterTan和PFNA治疗不稳定性股骨转子间骨折的疗效分析  

Efficacy Analysis of InterTan and PFNA in the Treatment of Unstable Intertrochanteric Fractures

作　　者：侯波[1] 刘涛[1] 曹富江[1] HOU Bo;LIU Tao;CAO Fu-jiang(Department of Orthopedics,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院骨科,天津300052

出　　处：《中国医药指南》2020年第16期9-11,共3页Guide of China Medicine

基　　金：国家自然科学基金项目资助(81871776,81401784)

摘　　要：目的比较InterTan和PFNA治疗不稳定性股骨转子间骨折的疗效。方法选择2015年1月至2018年1月收治的235例不稳定性转子间骨折患者,分别应用InterTan钉和股骨近端抗旋转钉(PFNA-Ⅱ)治疗。术后1、3、6和12个月进行随访。在每次随访采集X线照片。记录体位变化、并发症和固定失败例数。总共207例获得随访,平均随访8.36个月,对符合标准的患者进行评估。比较两组术中并发症和住院时间。结果使用PFNA-Ⅱ治疗的患者经历较短的透视时间和手术次数,术中出血少,股骨颈缩短少。PFNA-Ⅱ组大腿疼痛的发生率(23.4%)明显高于对照组(InterTan组)(11.3%)。组间比较,差异有显著性(P=0.001)。在最后的随访时全身并发症、局部并发症、行走能力、Harris髋关节评分,或髋关节运动范围无统计学显著差异。结论InterTan钉可能给患者带来更多的好处,但是对于不稳定性股骨转子间骨折还需要改进以减少术中并发症的难题。Objective To compare the efficacy of InterTan and PFNA in the treatment of unstable femoral intertrochanteric fractures.Methods A total of 235 patients with unstable intertrochanteric fractures from January 2015 to January 2018 who were treated with InterTan nail or proximal femoral anti-rotation nail(PFNA-Ⅱ).Follow-up was conducted at 1,3,6 and 12 months after surgery.Radiographs were obtained at each follow-up.Postural changes,complications,and number of fixation failures were recorded.A total of 207 patients were followed up,with an average follow-up of 8.36 months,and patients who met the criteria were evaluated.Comparison of intraoperative complications and hospital stay between the two groups.Results Patients treated with PFNA-Ⅱunderwent a shorter period of fluoroscopy and fewer surgical times,with less intraoperative bleeding and less femoral neck shortening.The incidence of thigh pain in the PFNA-Ⅱgroup(23.4%)was significantly higher than that in the control group(InterTan group)(11.3%).The comparison between the groups was significant(P=0.001).There were no significant differences in systemic complications,local complications,walking ability,Harris hip score,and hip range of motion at the final follow-up.Conclusion InterTan nails mayhave more benefits to patients,but for unstable femoral intertrochanteric fractures,improvements are needed to reduce the complications of intraoperative complications.

关 键 词：INTERTAN PFNA 不稳定性股骨转子间骨折 疗效 

分 类 号：R683.42[医药卫生—骨科学]