PFNA 内固定术和锁定钢板治疗老年股骨粗隆间骨折患者的疗效对比分析

Comparative analysis of PFNA internal fixation and locking plate on elderly patients with intertro-chanteric fracture

目的：分析 PFNA 内固定术和锁定钢板治疗老年股骨粗隆间骨折患者的疗效。方法选择2012年3月至2014年4月60例老年股骨粗隆间骨折患者，按照随机数表法将其分为观察组（30例）和对照组（30例）。观察组患者采用 PFNA 内固定术治疗，对照组患者采用锁定钢板治疗。记录和分析两组患者术中以及术后情况（手术时间、术中出血量、住院时间、负重时间、骨折愈合时间）、临床疗效（优、良、中、差）以及术后并发症发生情况（髋内翻、内固定松动、股骨头坏死、感染、其他）。结果观察组术中出血量[（141.1±23.5）ml]少于对照组[（223.4±35.8）ml]（P〈0.05）；观察组患者的住院时间、负重时间、骨折愈合时间均短于对照组患者，两组比较差异有统计学意义（P〈0.05）。观察组与对照组的优良率分别为93.33%与73.33%，观察组的临床疗效优于对照组（P〈0.05）。观察组与对照组的术后并发症发生率分别为6.67%与33.33%，两组比较差异有统计学意义（P〈0.05）。结论 PFNA 内固定术治疗老年股骨粗隆间骨折疗效良好，可以加快患者的愈合，且可以减少并发症的发生率，值得广泛推广使用。

Objective To analyze the curative effect of PFNA internal fixation and locking plate on elderly patients with intertrochanteric fracture. Methods Sixty cases of elderly femoral coarse inter-trochanteric fracture from March 2012 to April 2014 were researched according to the random number table method. The patients were divided into the observation group（30 cases）and the control group（30 cases）. Patients in the observation group were treated with PFNA internal fixation,and the control group were treated with locking plate. Recorded and analyzed the postoperative situation（operation time,intra-operative blood loss,hospitalization time,load time,healing time of fracture）,clinical efficacy（excel-lent,good,fair,poor）and postoperative complications（hip varus and internal fixation loosening,femo-ral head necrosis,infection,other）of the two groups. Results The intraoperative bleeding volume of observation group[（141. 1 ± 23. 5）ml]was less than that in the control group[（223. 40 ± 35. 80）ml] （P〈 0. 05）;the hospitalization time,load time,fracture healing time of observation group were signifi-cantly shorter than those in the control group（P〈 0. 05）. The excellent rate of observation group and control group were 93. 33% and 73. 33% ,and the clinical effect of observation group was better than that of control group（P〈 0. 05）. The incidence of postoperative complications in the observation group and the control group were 6. 67% and 33. 33% ,and there was significant difference between the two groups （P〈 0. 05）. Conclusions PFNA internal fixation in the treatment of femoral intertrochanteric fracture in elderly patients has good curative effect,it can accelerate the healing of patients and reduce the inci-dence of complications,so it is worthy of being promoting widely used in clinical.