两种术式治疗老年股骨转子间骨折的疗效比较  

Comparison effect of two kinds of internal fixation in the treatment of femoral intertrochanteric fracture in the elderly

作　　者：宋耀东 余润泽 SONG Yao-dong;YU Run-ze(Dept of Orthopaedics,Anhui No.2 Provincial People′s Hospital,Hefei,Anhui 230041,China)

机构地区：[1]安徽省第二人民医院骨科,安徽合肥230041

出　　处：《临床骨科杂志》2021年第4期571-574,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较股骨近端防旋髓内钉(PFNA)和股骨近端解剖锁定钢板(PFALP)治疗老年股骨转子间骨折的疗效。方法将60例老年股骨转子间骨折患者按照随机数字表法分为PFNA组和PFALP组,每组30例。比较两组手术时间、术中出血量、复位质量、术后下床活动时间、住院时间、术后开始负重时间、骨折愈合时间、骨痂形成情况。术后6个月采用Harris评分评价髋关节功能。结果患者均获得随访,时间11~15(12.82±1.67)个月。手术时间、术中出血量、住院时间、术后开始负重时间、骨折愈合时间PFNA组均明显短(少)于PFALP组(P <0.05);术后下床活动时间两组比较差异无统计学意义(P> 0.05);复位质量优良率、术后3个月骨痂形成优良率、术后6个月Harris评分优良率PFNA组均明显高于PFALP组(P <0.05)。结论与PFALP术式相比,采用PFNA治疗老年股骨转子间骨折具有创伤小、骨折愈合率高、术后并发症少等优点,可加快患者髋关节功能恢复,更利于提升患者生活质量。Objective To compare the effect of proximal femoral nail antirotation( PFNA) and proximal femoral anatomic locking plate( PFALP) in the treatment of elderly femoral intertrochanteric fracture. Methods The 60 cases of femoral intertrochanteric fractures were divided into PFNA group and PFALP group,each group had 30 cases,according to the random number table method. The operation time,intraoperative blood loss,reduction quality,movement time after operation,hospitalization time,weight-bearing time after operation,fracture healing time and callus formation time were compared between two groups. The hip function was evaluated with Harris scoring at 6 months postoperation. Results All patients were followed up for 11 ~ 15( 12. 82 ± 1. 67) months. Operation time,intraoperative bleeding volume,length of hospital stay,postoperative start weight-bearing time and fracture healing time of PFNA group were significantly shorter( less) than those of PFALP group( P < 0. 05). There was no statistical difference between the two groups in the postoperative out of bed activity time( P > 0. 05);the excellent-good rate of reduction quality,callus formation at 3 months and Harris score at 6 months were significantly higher in PFNA group than those in PFALP group( P < 0. 05). Conclusions Compared with PFALP operative method,the use of PFNA in the treatment of elderly femoral intertrochanteric fractures has the advantages of less trauma,high fracture healing rate,and fewer postoperative complications. It can speed up the recovery of hip joint function,and improve the living quality of patients.

关 键 词：股骨转子间骨折 股骨近端防旋髓内钉 股骨近端解剖锁定钢板 老年人 

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