两种内固定方式治疗老年股骨转子间骨折的疗效比较  

Effect comparison of two kinds of internal fixation methods for treatment of femoral intertrochanteric fractures in the elderly

作　　者：何涛 宋晓飞 侯绍平[1] 汪军[1] 龙俊任[1] 田龙 HE Tao;SONG Xiao-fei;HOU Shao-ping;WANG Jun;LONG Jun-ren;TIAN Long(Dept of Orthopaedics,the People's Hospital of Langzhong City,the Affiliated Langzhong Hospital of North Sichuan Medical College,Langzhong,Sichuan 637400,China)

机构地区：[1]阆中市人民医院(川北医学院附属阆中医院)骨科,四川阆中637400

出　　处：《临床骨科杂志》2023年第6期847-850,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较股骨近端防旋髓内钉(PFNA)与股骨近端锁定钢板(LPFP)治疗老年股骨转子间骨折的临床疗效。方法将90例老年股骨转子间骨折患者按内固定方式不同分成PFNA组(采用PFNA治疗,46例)和LPFP组(采用LPFP治疗,44例)。记录两组手术相关指标、术后并发症发生情况。采用Harris评分评价髋关节功能恢复情况。结果患者均获得随访,时间12~14(12.30±14.82)个月。切口长度、术中出血量、手术时间、术后引流量、住院时间PFNA组均短(少)于LPFP组(P<0.05);骨痂开始形成时间、骨折愈合时间、术后开始部分负重时间PFNA组均早于LPFP组(P<0.05)。术后3、12个月Harris评分及术后12个月的Harris评分优良率PFNA组均高于LPFP组(P<0.05)。术后并发症发生率PFNA组低于LPFP组(P<0.05)。结论与LPFP相比,PFNA治疗老年股骨转子间骨折更符合生物力学特点,具有创伤小、手术时间短、出血量少、并发症少的优点,更利于患者恢复髋关节功能,是治疗老年股骨转子间骨折的理想内固定术式。Objective To compare the clinical efficacy of proximal femoral nail antirotation(PFNA)and locking proximal femoral plate(LPFP)for treatment of the elderly femoral intertrochanteric fractures.Methods The 90 elderly patients with femoral intertrochanteric fractures were divieded into PFNA group(46 patients)and LPFP group(44 patients)by the different surgical methods.The related surgical indicators and postoperative complications were recorded.The functional recovery of hip joint was evaluated by Harris scores criterion.Results All patients were followed up for 12~14(12.30±14.82)months.The incision length,intraoperative blood loss,operation time,postoperative drainage volume,hosptialization time in the PFNA group were all shorter(less)than those in the LPFP group(P<0.05).The callus formation time,fracture healing time,postoperative starting partial weight-bearing time in the PFNA group were all earlier than those in the LPFP group(P<0.05).The Harris score at postoperative 3,12 months and the excellent-good rate of Harris score at 12 months after operation in PFNA group were higher than those in LPFP group(P<0.05).The incidence rate of postoperative complications of the PFNA group was lower than the LPFP group(P<0.05).Conclusions Compared with LPFP,PFNA treatment of elderly femoral intertrochanteric fractures is more suitable for biomechanical characteristics,which has the advantages of less trauma,short operation time,less blood loss and fewer complications,and is more conducive to the patients'hip function recovery,and is an ideal internal fixation method for treatment of elderly femoral intertrochanteric fractures.

关 键 词：股骨转子间骨折 内固定 股骨近端防旋髓内钉 股骨近端锁定钢板 老年人 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学] R687.33[医药卫生—临床医学]