不同固定方法治疗股骨转子间骨折的病例对照研究

Case control study of different fixing methods for intertrochanteric fractures

目的:比较不同固定方法治疗股骨转子间骨折的疗效,并做理论性分析。方法:自2003年6月至2007年6月采用Richard钉、PFN及外固定架治疗321例(男132例,女189例;年龄20～93岁,平均56.8岁)股骨转子间骨折患者,其中PFN组94例,Richard钉组142例,外固定架组85例。采用回顾性分析方法,内容包括并发症发生率及髋关节功能(采用Kudema改良MerliD'Aubigne标准从疼痛、运动幅度、步行等方面进行比较),并作统计学分析。结果:所有患者均获随访,时间10个月至4年,平均14个月。并发症发生率:外固定架组与其他两组之间存在统计学差异(P<0.05),而Richard钉组与PFN组之间无统计学差异(P>0.05)。髋关节功能:3组有统计学差异(P<0.05)。结论:3组固定方法比较,PFN的疗效最佳,并发症发生率较低,为目前治疗转子间骨折疗效较好的治疗方法。

Objective：To compare the clinical effects of different fixing methods for intertrochanteric fractures and make theoretical analysis. Methods：From June 2003 to June 2007,321 patients with intertrochanteric fractures,male 132 and fe-male 189,ranging in age from 20 to 93 years with an average of 56.8 years,were treated with different fixation including Richard nail（142 cases）,proximal femora nail（PFN,94 cases）and external fixator（85 cases）. The clinical data of all the pa-tients were retrospectively analyzed,including the incidence of compications,joint function of hip（according Kudema modified Merli D＇Aubigne criteria）. Results：All patients were followed up from 10 months to 4 years with an average of 14 months. About the incidence of complications,there was significant difference between the external fixator group and the others two groups （P0.05）;there was no significant difference between the Richard nail group and the PFN group （P0.05）. There was significant difference in joint function of hip among three methods. PEN group was best than others two groups. Conclusion： There is the best clinical effects and lowest incidence of complications with PFN method,which is the better choice in treating intertrochanteric fractures.