股骨近端防旋髓内钉远端不同锁定方式治疗不稳定型股骨转子间骨折的疗效比较  

Effect comparison of proximal femoral nail anti-rotation with different locking methods in the treatment of unstable femoral intertrochanteric fracture

作　　者：郑景陆[1] 杨雄健[1] 曹浩坤 ZHENG Jing-lu;YANG Xiong-jian;CAO Hao-kun(SectionⅣ,Dept of Orthopaedics,Zhongshan Hospital of TCM,Zhongshan,Guangdong 528400,China)

机构地区：[1]中山市中医院骨四科,广东中山528400

出　　处：《临床骨科杂志》2022年第2期236-241,共6页Journal of Clinical Orthopaedics

基　　金：广东省中山市卫生健康局医学科研项目(编号:2019J104)。

摘　　要：目的比较股骨近端防旋髓内钉(PFNA)远端静力化锁定和动力化锁定治疗不稳定型股骨转子间骨折的效果。方法将94例采用PFNA治疗的不稳定型股骨转子间骨折患者按主钉远端锁定方式不同分为静力化锁定组(51例)和动力化锁定组(43例)。采用Baumgaertner改良标准评价术后骨折复位质量,记录骨痂形成时间、骨折愈合时间和并发症发生情况,采用髋关节功能Harris评分标准评价疗效。结果患者均获得12个月随访。骨折复位质量两组比较差异无统计学意义(P>0.05)。骨痂形成时间、骨折愈合时间静力化锁定组均短于动力化锁定组(P<0.05)。术后并发症发生率动力化锁定组高于静力化锁定组(P<0.05)。末次随访时髋关节功能优良率静力化锁定组高于动力化锁定组(P<0.05)。结论采用PFNA治疗不稳定型股骨转子间骨折远端静力化锁定较动力化锁定骨折愈合时间更短,并发症更少,髋关节功能恢复更好。Objective To compare the effect of distal static locking and dynamic locking of proximal femoral nail anti-rotation(PFNA)in the treatment of unstable femoral intertrochanteric fractures.Methods The 94 patients with unstable intertrochanteric fractures who were treated with PFNA were divided into static locking group(51 cases)and dynamic locking group(43 cases),according to the different distal locking method of majoRnail.BaumgaertneRmodified criterion was used to evaluate the quality of postoperative fracture reduction.The callus formation time,fracture healing time and complications were recorded.The curative effect was evaluated by Harris score of hip function.Results All patients were followed up foR12 months.There was no difference in the fracture reduction quality between two groups(P>0.05).The callus formation time and fracture healing time in static locking group were less than those in dynamic locking group(P<0.05).The incidence rate of postoperative complications in dynamic locking group was higheRthan that in static locking group(P<0.05).At the last follow-up,the excellent and good rate of hip function in static locking group was higheRthan that in dynamic locking group(P<0.05).Conclusions In the treatment of unstable femoral intertrochanteric fracture with PFNA,compared with the dynamic locking,the static locking is safer,the healing time of the fracture is shorteRand the function of the hip joint is better.

关 键 词：股骨近端防旋髓内钉 股骨转子间骨折 静力化锁定 动力化锁定 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]