PFNA联合钢板或钢丝内固定与单纯PFNA内固定治疗外侧壁受累股骨转子间骨折的疗效  

Effiacy of PFNA combined with steel plate or steel wire internal fixation and PFNA internal fixation alone in the treatment of lateral wall-involved intertrochanteric fracture

作　　者：姚龙 王志强[2] 王兵 魏安程 黄鑫 YAO Long;WANG Zhiqiang;WANG Bing;WEI Ancheng;HUANG Xin(College of Medicine and Life Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,CHINA)

机构地区：[1]成都中医药大学医学与生命科学学院,四川611137 [2]遂宁市中心医院骨科 [3]宜宾市第六人民医院骨科

出　　处：《江苏医药》2024年第7期669-674,共6页Jiangsu Medical Journal

基　　金：四川省医学(青年创新)科研课题(Q19051)。

摘　　要：目的 比较防旋股骨近端髓内钉(PFNA)联合钢板或钢丝内固定与单纯PFNA内固定对外侧壁受累股骨转子间骨折的治疗效果。方法 外侧壁受累股骨转子间骨折患者41例,根据手术方式不同分为两组。A组(21例)采用PFNA联合钢板或钢丝内固定,B组(20例)采用单纯PFNA内固定。比较两组患者的临床资料、手术相关指标、手术相关并发症以及术后Harris髋关节评分(HHS)。结果 与B组比较,A组手术时间较长[150.13(129.50,172.50) min vs.80.20(70.20,90.31) min],术中出血量较多[500.21(450.21,600.21)mL vs.60.01(50.00,80.00) mL](P<0.05),两组住院时间和并发症发生率比较无统计学差异(P>0.05)。A组骨折愈合时间短于B组[(11.76±2.26)周vs.(15.00±1.52)周](P<0.05),术后12个月HHS高于B组[85.00(80.50,90.50)分vs.81.50(80.00,84.50)分](P<0.05)。结论 相较于单纯PFNA内固定,PFNA联合钢板或钢丝内固定治疗外侧壁受累股骨转子间骨折在骨折愈合时间、术后髋关节功能恢复方面具有一定优势,但会增加手术时间和术中出血量。Objective To compare the efficacy of proximal femoral nail anti-rotation(PFNA)combined with steel plate or steel wire internal fixation and PFNA internal fixation alone in the treatment of lateral wall-involved intertrochanteric fracture.Methods A total of 4l cases with lateral wall-involved intertrochanteric fracture were divided into two groups.Group A(21 cases)received PFNA combined with steel plate or steel wire internal fixation,and group B(20 cases)received PFNA internal fixation alone.The clinical data,surgery-related indexes,surgery-related complications and postoperative Harris hip score(HHS)were compared between the two groups.Results Compared with group B,group A had longer operation time[150.13(129.50,172.50)minutes vs.80.20(70.20,90.31)minutes] and more intraoperative blood loss[500.21(450.21,600.21)mL vs.60.01(50.00,80.00)mL](P<0.05).There were no significant differences in hospital stay and incidence of complications between the two groups(P>0.05).The fracture healing time of group A was shorter than that of group B[(11.76±2.26)weeks vs.(15.00±1.52)weeks](P<0.05).The HHS at 12 months after surgery of group A was higher than that of group B[85.00(80.50,90.50)points vs.81.50(80.00,84.50)points](P<0.05).Conclusion In the treatment of lateral wall-involved intertrochanteric fracture,compared with PFNA internal fixation alone,PFNA combined with steel plate or steel wire internal fixation has the certain advantages of shorter fracture healing time and better postoperative hip functional recovery,but is with increased operative time and intraoperative blood loss.

关 键 词：股骨转子间骨折 外侧壁 防旋股骨近端髓内钉 钢板 钢丝 

分 类 号：R683[医药卫生—骨科学]