半髋关节置换与PFNA在治疗不稳定型股骨粗隆间骨折的临床分析

Clinical Analysis of Hemiarthroplasty and PFNA for Treatment of Femoral Unstable Intertrochanteric Fracture

目的探讨不稳定型股骨粗隆间骨折采用半髋关节置换与PFNA内固定两种手术方式的疗效。方法回顾性分析我院2009年1月至2011年12月间接受PFNA内固定及半髋关节置换治疗不稳定型股骨粗隆间患者的临床资料。比较两种治疗方法的切口长度、手术时间、术中出血量、术后输血量、髋关节活动时间、术后卧床时间、内科合并症、内植物并发症的指标。结果两组平均随访12个月,PFNA组临床更具微创性,半髋关节置换组术后并发症更少。结论 PFNA及半髋关节置换术均为治疗粗隆间不稳定型骨折的有效方法,对于骨质较好的年轻患者可选择PFNA,但对于合并症多,骨质疏松患者选择半髋关节置换术更为合理。

Objective To discuss the curative effect of proximal femoral nail antirotation （PFNA） and hemiarthroplasty in the treatment of femoral unstable intertrochanteric fracture. Methods The clinical data of patients with femoral unstable intertrochanteric fracture accepted PFNA or hemiarthroplasty in our hospital from January 2009 to December 2012 were analyzed retrospectively. The length of incision, operative time, intraoperative blood loss, postoperative blood transfusion volume, hip joint activity time, postoperative bed time, medical complications, the indicator of internal implant complications between two operative methods were compared. Results The mean follow-up period was 12 months in two groups. Compared with the cases of hemiarthroplasty, the cases of PFNA fixation was minimally invasive. Hemiarthroplasty has less complication. Conclusions Both of the two methods are reasonable in the treatment of femoral unstable intertrochanteric fracture .Young patients with bone of good quality can choose PFNA. Patients of osteoporosis and more complication are reasonable to choose hemiarthroplasty.