两种髓内钉治疗高龄不稳定型股骨转子间骨折的效果比较  

Comparison of two kinds of intramedullary nailing in the treatment of senile unstable intertrochanteric fractures

作　　者：王海川 桑原田 WANG Haichuan;SANG Yuantian(Department of Orthopedics,the Fifth People's Hospital of Dalian City,Liaoning Province,Dalian 116023,China)

机构地区：[1]大连市第五人民医院骨一科,辽宁大连116023

出　　处：《中国当代医药》2022年第8期79-82,共4页China Modern Medicine

摘　　要：目的比较InterTAN髓内钉与股骨近端防旋髓内钉(PFNA)治疗高龄不稳定型股骨转子间骨折的效果。方法回顾性分析2016年3月至2020年6月大连市第五人民医院收治的76例高龄不稳定型股骨转子间骨折患者临床资料,根据不同内固定方式分为InterTAN组(39例)和PFNA组(37例)。InterTAN组采用InterTAN髓内钉固定,PFNA组采用防旋股骨近端防旋髓内钉固定。术后均进行至少1年的随访,比较两组患者的手术时间、术中出血量、术后并发症发生情况、下地时间、骨愈合时间及术后髋关节功能。结果两组患者的下地时间、骨愈合时间及术后髋关节功能比较,差异无统计学意义(P>0.05)。PFNA组手术时间短于InterTAN组,术中失血量均少于InterTAN组,差异有统计学意义(P<0.05)。InterTAN组的大腿疼痛发生率低于PFNA组,差异有统计学意义(P<0.05)。结论两种髓内钉内固定治疗不稳定型股骨近端骨折均能获得良好疗效,InterTAN术后并发症较少,而PFNA手术操作较简便,手术时间较短、损伤小,可能更适合高龄、内科合并症多、重度骨质疏松患者的手术治疗。Objective To compare the efficacy of InterTAN intramedullary nail and proximal femoral anti-rotation intramedullary nail(PFNA)in the treatment of elderly unstable intertrochanteric fractures.Methods A retrospective analysis was performed on the clinical data of 76 elderly patients with unstable intertrochanteric fractures admitted to the Fifth People's Hospital of Dalian City from March 2016 to June 2020.According to different internal fixation methods,they were divided into InterTAN group(39 cases)and PFNA group(37 cases).InterTAN group was fixed with InterTAN intramedullary nail,and PFNA group was fixed with anti-rotation femoral proximal intramedullary nail.All patients were followed up for at least 1 year after surgery,and the operative time,intraoperative blood loss,postoperative complications,ground time,bone union time and postoperative hip function of the two groups were compared.Results There were no significant differences in ground time,bone healing time and postoperative hip function between two groups(P>0.05).The operative time of PFNA group was shorter than that of InterTAN group,and the intraoperative blood loss was lower than that of InterTAN group,the differences were statistically significant(P<0.05).The incidence of thigh pain in InterTAN group was lower than that in PFNA group,the difference was statistically significant(P<0.05).Conclusion Both kinds of intramedullary nail fixation can achieve good efficacy in the treatment of unstable proximal femoral fracture.InterTAN has fewer postoperative complications,while PFNA is more convenient,shorter operation time and less injury,which may be more suitable for the surgical treatment of elderly patients with more medical complications and severe osteoporosis.

关 键 词：高龄 重度骨质疏松 股骨转子间不稳定型骨折 髓内钉 

分 类 号：R683[医药卫生—骨科学]