PFNA和股骨头置换治疗股骨粗隆间骨折的疗效研究

The Clinical Effects of PFNA and Femoral Head Replacement in Treatment of Femoral Intertrochanteric Fractures

目的:对比观察闭合复位股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)内固定与股骨头置换两种手术方法治疗股骨粗隆间骨折的疗效。方法:回顾性研究2008年12月-2010年12月笔者所在医院收治的86例股骨粗隆间骨折患者,其中采用闭合复位PFNA内固定(A组)48例,股骨头置换(B组)38例。平均随访时间18.5个月(12～35个月)。对比分析两组在手术时间、术中出血量、住院费用、术后下地活动时间、Harris评分的差异。结果:A组手术时间、术中出血量、住院费用明显低于B组,术后下地活动时间A组短于B组,Harris术后3月差异无统计学意义,术后6月、术后1年A组大于B组。结论:两种手术方法对于股骨粗隆间骨折均为治疗股骨粗隆间骨折的有效措施,闭合复位PFNA内固定,创伤小,费用低,中远期疗效肯定,是较理想的治疗老年股骨粗隆间骨折的方法。

Objective ： To study the clinical effects of closed reduction and PFNA internal fixation and femoral head replacement surgery on treatment of femoral intertrochanteric fractures. Methods ： 86 cases of femoral intertrochanteric fractures were treated with closed reduction and PFNA internal fixation （48） or femoral head replacement （38）. The followup time was 18.5 months .The operation time, volume of blood during operation , cost of hospitalization, exercise time and Harris score were analazed. Results ：The operation time, volume of blood during operation, cost of hospitalization and exercise time postoperation in group A were lower than that in group B. Harris score was no statistics differences in 3 months, and A was more than which of group B in 6 months and 12 months between 2 groups. Conclusion ：The two methods are effective for femoral intertrochanteric fractures. The method of closed reduction and PFNA internal fixation is less invasive, and lower cost, and certainly in the long-term efficacy. It is a better treatment for femoral intertrochanteric fracture method..