两种术式治疗老年股骨转子间不稳定骨折的疗效比较  

The effect comparison of the two methods in the treatment of elderly unstable intertrochanteric fractures

作　　者：王玉川[1] 陈洁 李智[1] 杜美廷 WANG Yu-chuan;CHEN Jie;LI Zhi;DU Mei-ting(Dept of Trauma Orthopedics,Dazhou Central Hospital,Dazhou,Sichuan 635000,China)

机构地区：[1]达州市中心医院创伤骨科,四川达州635000 [2]不详

出　　处：《临床骨科杂志》2020年第4期563-566,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较股骨近端防旋髓内钉(PFNA)与股骨近端锁定板(PFLAP)治疗老年股骨转子间不稳定骨折患者的疗效。方法将73例老年股骨转子间不稳定骨折患者根据治疗方法不同分为对照组(35例)和观察组(38例),分别采用PFLAP和PFNA内固定治疗。观察切口长度、术中出血量、手术时间、下床活动时间、住院时间、首次负重时间、骨折愈合时间等指标,采用Harris评分评价髋功能。结果患者均获得12个月随访。下床活动时间、住院时间、骨折愈合时间两组比较差异均无统计学意义(P>0.05)。切口长度、术中出血量、手术时间、首次负重时间观察组均优于对照组(P<0.05)。术后12个月,活动范围、关节功能、畸形方面两组比较差异均无统计学意义(P>0.05),关节疼痛评分、Harris总分观察组显著高于对照组(P<0.05)。结论PFLAP与PFNA内固定均是老年股骨转子间不稳定骨折有效的治疗方式,患者切口长度、术中出血量、手术时间、首次负重时间及关节疼痛评分、Harris总分PFNA优于PFLAP。Objective To compare the effect of proximal femoral nail anti-rotation(PFNA)and proximal femoral locking plate(PFLAP)in the treatment of elderly patients with unstable intertrochanteric fractures.Methods The 73 elderly patients with unstable intertrochanteric fractures were divided into control group(35 cases)and observation group(38 cases)according to the different treatment methods,PFLAP and PFNA internal fixation were used,respectively.The incision length,intraoperative bleeding volume,operation time,time of ambulation,hospitalization days,the first loading time,fracture healing time etc index were recorded,and Harris score was used to evaluate the hip function.Results All patients were followed up for 12 months.There were no statistical differences between the two groups in terms of ambulation time,length of hospital stay,healing time.The incision length,intraoperative blood loss volume,operation time and start weight-bearing time in the observation group were all better than those in the control group(P<0.05).At 12 months postoperation,there were no statistical significances between two groups in terms of range of activity,joint function and deformity(P>0.05).The pain VAS of joint,the total Harris scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusions PFLAP and PFNA internal fixation are both effective treatment methods for elderly unstable intertrochanteric fractures.The incision length,intraoperative blood loss volume,operation time,the first loading time etc indexes and joint pain VAS,total Harris scores of the patients treated with PFNA are superior to PFLAP.

关 键 词：股骨转子间不稳定骨折 股骨近端防旋髓内钉 股骨近端锁定板 髋关节功能 

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