两种方法治疗股骨转子间骨折的疗效比较  

Effect comparison of two kinds of methods in the treatment of femoral intertrochanteric fractures

作　　者：陈焕杰 卢鸿 曹园 CHEN Huan-jie;LU Hong;CAO Yuan(Dept of Orthopaedics, the People′s Hospital of Honghu City,Honghu,Hubei 433200,China;Dept of Orthopaedics,the Affiliated Hospital of Hubei University of Arts and Science, Xiangyang Central Hospital, Xiangyang, Hubei 441021,China)

机构地区：[1]洪湖市人民医院骨科,湖北洪湖433200 [2]湖北文理学院附属医院,襄阳市中心医院骨科,湖北襄阳441021

出　　处：《临床骨科杂志》2020年第6期840-843,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较股骨近端解剖锁定钢板(PFALP)与股骨近端防旋髓内钉(PFNA)治疗股骨转子间骨折的临床疗效。方法将160例股骨转子间骨折患者根据治疗方式不同分为PFALP组和PFNA组,各80例。比较两组手术情况、术后不同时间段Harris评分及术后并发症发生情况,术后12个月根据Harris评分标准评价髋关节功能。结果患者均获得12个月随访。手术时间、术中出血量、术后引流量、下地活动时间PFNA组均优于PFALP组(P<0.05)。术后12个月髋关节功能优良率PFNA组为80.0%,PFALP组为77.5%,两组比较差异无统计学意义(P>0.05)。出院时及术后3、6、9、12个月Harris评分PFNA组均高于PFALP组(P<0.05)。并发症发生率PFNA组(11.25%)低于PFALP组(28.75%)(P=0.003)。结论PFALP与PFNA均是治疗老年股骨转子间骨折的有效手术方式,但PFNA手术时间短,患者可早期下床活动,并发症发生率低,临床疗效更好。Objective To compare the clinical effect of proximal femoral anatomic locking plate(PFALP)and proximal femoral nail antirotation(PFNA)in the treatment of femoral intertrochanteric fractures.Methods The 160 cases of femoral intertrochanteric fractures were included,according to the different treatment methods,they were divided into PFNA group(n=80)and PFALP group(n=80).The surgical conditions,postoperative Harris score at different time points,incidence of postoperative complications of the two groups were compared.At 12 months postoperation,the hip function was evaluated with Harris score criterion.Results All patients were followed up for 12 months after operation.The operation time,intraoperative bleeding volume,postoperative drainage volume,the loading activity time of the PFNA group were better than the PFALP group(P<0.05).At 12 months after operation,for hip function,the excellent-good rate of the PFNA group was 80.0%(64/80),which of the PFALP group was 77.5%(62/80),there was no significant difference between the two groups(P>0.05).At leaving hospital,3,6,9,12 months after operation,the Harris score of the PFNA group were higher than those of the PFALP group(P<0.05).The complication incidence rate of the PFNA group(11.25%)was lower than that of the PFALP group(28.75%)(P=0.003).Conclusions PFALP and PFNA are effective methods for treatment of femoral intertrochanteric fractures,but PFNA is better than PFALP in operation time,early rehabilitatian,and the occurrence of postoperative complications is lower,the effect is better.

关 键 词：股骨转子间骨折 股骨近端解剖锁定钢板 股骨近端防旋髓内钉 

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