加长PFNA-Ⅱ治疗老年股骨转子部粉碎性骨折疗效观察

Efficacy of lengthened PFNA-Ⅱ in the treatment of elderly patients with intertrochanteric comminuted fractures

目的：探讨加长抗旋股骨近端髓内钉-Ⅱ（PFNA-Ⅱ）内固定术治疗老年股骨转子部粉碎性骨折（ITCF）的疗效。方法：实施加长PFNA-Ⅱ内固定术治疗的30例老年ITCF患者为观察组,实施动力髋螺钉内固定术治疗的30例老年ITCF患者为对照组;术后随访6-24个月,比较两组疗效。结果：两组手术、卧床、下地负重时间比较差异无统计学意义（P〉0.05）;观察组显性失血及总失血量少于对照组,但隐性失血量多于对照组（P〈0.05）;观察组骨折愈合时间短于对照组（P〈0.05）;术后3个月、6个月观察组髋关节活动度评分高于对照组（P〈0.05）;术后3个月两组髋关节Harris评分比较差异无统计学意义,术后6个月观察组Harri评分高于对照组（P〈0.05）;观察组并发症发生率低于对照组（P〈0.05）。结论：加长PFNA-Ⅱ内固定术治疗老年ITCF疗效显著,术后髋关节功能恢复良好,并发症少。

Objective：To investigate effect of lengthened PFNA-Ⅱ in the treatment of elderly patients with ITCF.Methods：30elderly patients with ITCF（the observation group）were prospective underwent lengthened PFNA-Ⅱinternal fixation,and retrospective analysis of clinical dates of 30 patients with ITCF（the control group）whom underwent Dynamic Hip screw fixation,all patients were followed up for 6to 24 months to compare the treatment efficacy.Results：The operation time,bed time,weight-bearing time between 2groups was not statistically significant（P〈0.05）;dominant hemorrhagic and total blood loss in the observation group was less than that in the control group,but hidden blood loss was more than that in the control group（P〈0.05）;the observation group fracture healing time shorter than the control group（P〈0.05）;hip activity score in the observation group were higher（P〈0.05）;3months later,harris hip score between 2groups was not statistically significant,but 6months later,harri hip score in the observation group was higher than that in the control group（P〈0.05）;the incidence of complications in the observation group was less than that in the control group（P〈0.05）.Conclusion：Lengthened PFNA-Ⅱin the treatment of elderly patients with ITCF has significant effect,postoperative hip function recovered well,fewer complications,worthy of promotion apply.