股骨近端防旋髓内钉与股骨近端交锁髓内钉在治疗老年股骨粗隆间骨折的近远期疗效  

Short and Long Term Efficacy of PFNA and InterTAN in the Treatment of Intertrochanteric Femoral Fractures in the Elderly

作　　者：马宁 MA Ning(Department of Orthopedics,Nanjing Jiangning Hospital,Nanjing 211100,Jiangsu,China)

机构地区：[1]南京市江宁医院骨科,江苏南京211100

出　　处：《世界复合医学（中英文）》2024年第8期107-110,140,共5页World Journal of Complex Medicine

摘　　要：目的分析股骨近端防旋髓内钉(proximal femoral nail anti-rotation in tram edullary,PFNA)与股骨近端交锁髓内钉(interlocking i ntramedullary nail for proximal femur,InterTAN)内固定手术在老年股骨粗隆间骨折患者中的治疗效果。方法回顾性选取2021年8月—2022年5月南京市江宁医院收治的60例股骨粗隆间骨折患者的临床资料,根据术式不同将其分为PFNA组(n=35)和InterTAN组(n=25),PFNA组患者采用PFNA内固定手术治疗,InterTAN组采用InterTAN内固定手术治疗。比较两组患者的手术指标(手术时间、术中出血量、术后卧床时间,骨折愈合时间)、于术前和术后1周比较两组患者炎症水平[白细胞水平、血清超敏C-反应蛋白(hypersensitive C-reactive-protein,hs-CRP)和白细胞介素-6(interleukin 6,IL-6)水平],于术后3个月、6个月、1年比较患者Harris髋关节评分及术后并发症发生情况。结果PFNA组的手术、术后卧床和骨折愈合时间均短于InterTAN组,术中出血量少于InterTAN组,差异有统计学意义(P均<0.05)。术后1周,两组患者白细胞、hs-CRP、IL-6水平均高于术前,且PFNA组白细胞、hs-CRP、IL-6水平均低于InterTAN组,差异有统计学意义(P均<0.05)。术后3个月、术后6个月和术后1年PFNA组的Harris髋关节评分均高于InterTAN组,差异有统计学意义(P均<0.05)。PFNA组患者的并发症反应率为22.86%(8/35),高于InterTAN组的4.00%(1/25),差异有统计学意义(χ^(2)=4.067,P<0.05)。结论相较于InterTAN,PFNA内固定手术对老年股骨粗隆间骨折患者具有较好的治疗效果,手术时间短,患者术后恢复情况好,髋关节功能改善更佳,患者远期预后较好,但PFNA并发症发生率更高。Objective To analyze the therapeutic effect of proximal femoral nail anti-rotation(PFNA)and interlocking intramedullary nail for proximal femur(InterTAN)internal fixation in elderly patients with intertro⁃chanteric fracture of femur.Methods The clinical data of 60 patients with femoral intertrochanteric fractures ad⁃mitted to Nanjing Jiangning Hospital from August 2021 to May 2022 were retrospectively selected.According to different surgical methods,they were divided into PFNA group(n=35)and InterTAN group(n=25).Patients in PFNA group were treated with PFNA internal fixation,and patients in InterTAN group were treated with Inter⁃Tan internal fixation.The operation indexes(operation time,intraoperative blood loss,postoperative bed rest time,fracture healing time)were compared between the two groups.The levels of inflammation[white blood cell level,serum hypersensitive C-reactive protein(hs-CRP)and interleukin 6(IL-6)]were compared between the two groups before and 1 week after operation.The Harris Hip Score and postoperative complications were com⁃pared at 3 months,6 months and 1 year after operation.Results The operation,postoperative bed rest and frac⁃ture healing time of PFNA group were shorter than those of InterTAN group,and the intraoperative blood loss was less than that of InterTAN group,the differences were statistically significant(all P<0.05).At 1 weeks after operation,the levels of white blood cells,hs-CRP and IL-6 in the two groups were higher than those before op⁃eration,and the levels of white blood cells,hs-CRP and IL-6 in the PFNA group were lower than those in the InterTAN group,the differences were statistically significant(all P<0.05).The Harris Hip Score of PFNA group were higher than that of InterTAN group at 3 months,6 months and 1 year after operation,and the difference were statistically significant(all P<0.05).The complication response rate of PFNA group was 22.86%(8/35),which was higher than that of InterTAN group 4.00%(1/25),the difference was statistically significant(χ^(2

关 键 词：股骨粗隆间骨折 内固定 股骨近端防旋髓内钉 股骨近端交锁髓内钉 

分 类 号：R4[医药卫生—临床医学]