PFN、PFNA及InterTAN髓内钉治疗老年股骨粗隆间骨折的效果比较  

Comparison of Effects of PFN,PFNA and InterTAN Intramedullary Nails in the Treatment of Intertrochanteric Fractures of Femur in Elderly

作　　者：李国晨 丁建丽 张朝[2] LI Guochen;DING Jianli;ZHANG Zhao(Graduate School of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040,China;不详)

机构地区：[1]内蒙古科技大学包头医学院研究生院,内蒙古包头014040 [2]内蒙古科技大学包头医学院第一附属医院

出　　处：《中国医学创新》2021年第15期136-139,共4页Medical Innovation of China

摘　　要：目的:比较临床中传统股骨近端髓内钉(proximal femoral nail,PFN)、股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)及InterTAN髓内钉治疗老年股骨粗隆间骨折的临床效果。方法:回顾性分析2018年8月-2020年4月包头医学院第一附属医院收治的98例老年股骨粗隆间骨折患者的资料。根据内固定方式不同将其分为三组,PFN组33例,PFNA组37例,InterTAN髓内钉组28例。比较三组手术时间、术中出血量、术后Harris髋关节功能评分和术后相关并发症发生情况。结果:三组手术时间、术中出血量和术后Harris髋关节功能评分比较,差异均有统计学意义(P<0.05)。PFNA组手术时间和术中出血量均低于InterTAN组和PFN组,InterTAN组手术时间和术中出血量均低于PFN组,差异均有统计学意义(P<0.05)。InterTAN组术后Harris髋关节功能评分明显高于PFN组和PFNA组,差异均有统计学意义(P<0.05)。PFNA组与PFN组术后Harris髋关节功能评分比较,差异无统计学意义(P>0.05)。三组患者术后并发症发生率比较,差异有统计学意义(P<0.05)。PFN组术后并发症发生率高于PFNA组和InterTAN组,差异有统计学意义(P<0.05)。结论:三种髓内钉均可以治疗老年股骨粗隆间骨折,但是对于全身情况差、内科疾病多、手术风险较大的患者,PFNA能够有效地缩短手术时间、减少出血量;对于骨质疏松、稳定性较差的患者,InterTAN能提供良好的稳定性,减少术后并发症,优势更加明显。Objective:To compare the clinical effects of traditional proximal femoral nail(PFN),proximal femoral nail antirotation(PFNA)and intertan intramedullary nail in the treatment of intertrochanteric fractures of femur in elderly.Method:The data of 98 elderly patients with intertrochanteric fracture of femur treated in the First Affiliated Hospital of Baotou Medical College from August 2018 to April 2020 were retrospectively analyzed.According to different internal fixation methods,they were divided into three groups,PFN group(33 cases),PFNA group(37 cases)and InterTAN group(28 cases).The operation time,intraoperative blood loss,Harris hip function score and postoperative related complications were compared among three groups.Result:The operation time,intraoperative blood loss and Harris hip function score were compared among three groups,the differences were statistically significant(P<0.05).The operation time and blood loss of PFNA group were lower than those of InterTAN group and PFN group,the operation time and blood loss in InterTAN group were lower than those in PFN group,the differences were statistically significant(P<0.05).The Harris hip function score of InterTAN group was significantly higher than those of PFN group and PFNA group,the differences were statistically significant(P<0.05).There was no significant difference in Harris hip function score between PFNA group and PFN group(P>0.05).Comparison of the total incidence of postoperative complications among three groups,the difference was statistically significant(P<0.05).The incidence of postoperative complications in PFN group was higher than those in PFNA group and InterTAN group,the differences were statistically significant(P<0.05).Conclusion:All three kinds of intramedullary nails can treat the intertrochanteric fracture of femur in elderly.However,for the patients with poor general condition,many medical diseases and high operation risk,PFNA can effectively shorten the operation time and reduce the amount of bleeding.For patients with osteoporosis a

关 键 词：老年股骨粗隆间骨折 INTERTAN PFN PFNA 

分 类 号：R687.3[医药卫生—骨科学]