经皮TriGen髓内钉与股骨近端髓内钉治疗老年股骨转子间骨折的疗效比较

Comparative study on clinical effect of percutaneous Trigen nail and proximal femoral nail in treatment of femoral intertrochanteric fractures in the elderly

目的 比较经皮TriGen髓内钉（美国Smith Nephew公司）与股骨近端髓内钉（PFN）（瑞士AO／SYNTHES公司）治疗股骨转子间骨折的临床疗效，探讨治疗老年股骨转子间骨折更为合理的方法。方法 分析本院2001年10月-2005年1月收治的股骨转子间骨折患者56例，年龄〉60岁。随机分为两组：A组21例，采用经皮TriGen髓内钉固定；B组35例，采用PFN固定。对两组手术切口长度、手术时间、术中出血量、术中输血、术后引流量、骨折愈合时间、术后至出院时间、髋关节功能优良率进行分析比较。结果 两组间手术切口长度、手术时间、术中出血量、输血量、术后引流量、手术至出院时间比较，差异均有统计学意义（P〈0．05）。术后部分负重时间、骨折愈合时间、髋关节功能评价等差异均无统计学意义。结论 与PFN固定相比，经皮TriGen髓内钉具有手术时间短、出血量少、手术组织损伤小等优点，降低了手术风险，用于治疗老年股骨转子间骨折具有一定优势。

Objective To compare the clinical therapeutic effects of percutaneous TriGen （ Smith Nephew） nail and proximal femoral nail （PFN, AO/SYNTHES） in treatment of femoral intertrochanteric fractures of the elderly so as to discuss a reasonable treatment method for the aged patients. Methods A retrospective study was done on data of 56 patients （ at age of over 60 years） with femoral intertrochanterie fractures treated in our hospital from October 2001 to January 2005. They were divided into Group A （21 patients, treated with percutaneous TriGen nail） and Group B （35 patients, treated with PFN）. The incision length, operating period, intraoperative blood loss, blood transfusion, postoperative drainage, time of bone union, duration of in-patient stay and excellent rate of hip function in Groups A and B were analyzed and compared. Results There was a significant difference between Group A and Group B in the length of incision, operating period, intraoperative blood loss, blood transfusion, postoperative drainage and duration of in-patient stay （P 〈0.05）. No statistical difference was found between Group A and Group B in the partial weight-bearing time, time of bone union and hip score. Conclusions Compared with PFN, percutaneous TriGen nail has the advantages of less operative invasion and blood loss, shorter operating period and less surgical risk and is one of good choices for treatment of femoral intertrochanteric fractures in the elderly.