PFNA与PFNA-2治疗老年股骨转子间骨折的疗效比较  

The comparison of PFNA and PFNA-2 in the treatment of intertrochanteric fracture of femur in elderly patients

作　　者：张昭军[1] 袁风雷 张丽霞 韩守江[1] 王斌[1] 张合[1] 刘巍 刘晓宁[4] Zhang Zhaojun;Yuan Fenglei;Zhang Lixia;Han Shoujiang;Wang Bin;Zhang He;Liu Wei;Liu Xiaoning(Third Department Of Orthopedics,General Hospital of Jizhong energy Fengfeng Group Corporation,Handan056004,China;Department Of Anesthesiology;Department Of Medicine,Hebei Metallurgical Construction Staff Hospital,Handan 056004,China;First Department Of Orthopedics,General Hospital of Jizhong energy Fengfeng Group Corporation,Handan 056004,China)

机构地区：[1]邯郸冀中能源峰峰集团有限公司总医院邯郸院区骨三科,056004 [2]邯郸冀中能源峰峰集团有限公司总医院邯郸院区麻醉科,056004 [3]河北冶建职工医院内科,邯郸056004 [4]邯郸冀中能源峰峰集团有限公司总医院邯郸院区骨一科,056004

出　　处：《中华老年骨科与康复电子杂志》2021年第2期111-116,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：河北省卫计委科技计划项目(20191178)。

摘　　要：目的探讨比较传统型股骨近端防旋髓内钉(PFNA)与亚洲型股骨近端防旋髓内钉(PFNA-2)治疗老年股骨转子间骨折(IFF)的疗效。方法前瞻性收集2017年1月至2019年1月本院老年IFF患者200例,依据随机数字表分为PFNA组和PFNA-2组,每组100例,PFNA组给予PFNA内固定治疗,PFNA-2组给予PFNA-2内固定治疗,比较两组手术及康复情况、并发症、髋关节功能、死亡情况。结果所有患者均顺利完成内固定手术,出院后均获得12~26个月随访,平均随访时间为(18.2±2.7)个月。PFNA-2组术中出血量、手术时间、透视次数[(102±13)ml、(61±8)min、(9.8±1.0)次]低于PFNA组[(133±17)ml、(70±9)min、(12.8±1.5)次],差异有统计学意义(P<0.05),PFNA组和PFNA-2组切口长度、住院时间、部分负重时间、完全负重时间、骨折愈合时间[(4.3±0.6)cm、(7.8±1.1)d、(7.8±1.2)w、(13.3±1.9)w、(14.7±2.1)w和(4.2±0.6)cm、(7.6±1.0)d、(7.7±1.2)w、(13.0±1.8)w、(14.4±2.0)w]比较,差异无统计学意义(P>0.05);PFNA-2组并发症发生率(10.00%)低于PFNA组(34.00%),差异有统计学意义(P<0.05);PFNA组和PFNA-2组Harris评分优良率(92.00%、94.00%)比较,差异无统计学意义(P>0.05);PFNA组和PFNA-2组死亡率(14.00%、10.00%)比较,差异无统计学意义(P>0.05)。结论与PFNA比较,PFNA-2可有效减少老年IFF患者手术创伤及操作难度,有利于减少患者并发症,且具有良好的治疗疗效,值得临床推广。Objective To discuss the comparison of traditional typeproximal femoral nail anti-rotation(PFNA)and Asian typeproximal femoral nail anti-rotation(PFNA-2)in the treatment of intertrochanteric fracture of femur(IFF)in elderly patients.Methods Two hundred elderly patients with IFF in our xxxhospital from January 2017 to January 2019 were selected,and they were divided into PFNA group and PFNA-2 group according to the random number table,with 100 cases in each group.The PFNA group was treated with PFNA internal fixation,and the PFNA-2 group was treated with PFNA-2 internal fixation,the operation and rehabilitation,complications,hip function,death were compared between the two groups.Results All patients successfully completed the internal fixation operation and were followed up for 12 to 26 months after discharge.The average follow-up time was(18.2±2.7)months.The intraoperative bleeding volume,operation time,fluoroscopy times in the PFNA-2 group[(102±13)ml,(61±8)min,(9.8±1.0)times]were significantly lower than those in the PFNA group[(133±17)ml,(70±9)min,(12.8±1.5)times],the difference was statistically significant(P<0.05),there was no significant difference in the incision length,hospitalization time,partial weight-bearing time,complete weight-bearing time and fracture healing time betweenthe PFNA group and PFNA-2 group[(4.3±0.6)cm,(7.8±1.1)d,(7.8±1.2)weeks,(13.3±1.9)weeks,(14.7±2.1)weeks and(4.2±0.6)cm,(7.6±1.0)d,(7.7±1.2)weeks,(13.0±1.8)weeks,(14.4±2.0)weeks].The complication rate in the PFNA-2 group(10.00%)were significantly lower than those in the PFNA group(34.00%),the difference was statistically significant(P<0.05).There was no significant difference in the excellent rate of Harris score between the PFNA group and PFNA-2 group(92.00%,94.00%),the difference was not statistically significant(P>0.05).There was no significant difference in the death rate between PFNA group and PFNA-2 group(14.00%,10.00%),the difference was not statistically significant(P>0.05).Conclusions Compared with PFNA,the P

关 键 词：髋骨折 传统 亚洲 内固定 疗效 

分 类 号：R687.3[医药卫生—骨科学]