股骨近端防旋髓内钉与锁定钢板治疗股骨近端骨折的疗效比较

Comparison of clinical effective of proximal femoral nail anti-rotation and locking plate for proximal femoral fractures

目的比较股骨近端防旋髓内钉(PFNA)与锁定钢板治疗股骨近端骨折的临床疗效。方法将232例股骨近端骨折患者随机分为PFNA组(120例)与锁定钢板组(112例)。PFNA组患者采用股骨近端防旋髓内钉内固定治疗,锁定钢板组患者采用锁定钢板内固定治疗,以术中失血量、手术时间、术中透视时间、术后并发症及髋关节功能恢复情况为观察指标。结果 PFNA组患者术中失血量、手术时间与术中透视时间分别为(84.5±13.6)mL、(45.7±4.9)min、(185.3±12.5)s,锁定钢板组患者术中失血量、手术时间与术中透视时间分别为(88.2±14.5)mL、(46.9±5.1)min、(190.6±10.4)s,2组比较,P>0.05,差异无显著性。2组术后髋关节功能恢复情况比较,P>0.05,差异无显著性。2组均出现断钉及股骨头切割各2例。结论股骨近端防旋髓内钉与锁定钢板均是治疗股骨近端骨折较好的内固定材料。

Objective To compare the clinical effects of proximal femoral nail anti-rotation （PFNA） and locking plate for the treatment of proximal femoral fractures. Methods 232 patients with proximal femoral fractures were randomly divided into PFNA group （ 120 cases） and locking plate group （112 cases）. Patients in PFNA group were treated with proximal femoral nail internal fixation and patients in locking plate group were received locking plate internal fixation. The intraoperative blood loss, operative time, intraoperative fluoroscopy time, postop- erative complications and hip joint functional recovery were observed. Results The intraoperative blood loss, operative time and intraopera- rive fluoroscopy time were respectively （84.5 ± 13.6） mL, （45.7 ±4.9） min, （ 185.3± 12.5） s in PFNA group,and the intraoperative blood loss, operative time and intraoperative fluoroscopy time were respectively （88.2 ±14.5 ） mL, （46.9 ±5.1 ） rain, （ 190.6± 10.4 ） s in locking plate group. There was no significant difference between two groups（ P 〉 0.05 ）. There was no significant difference in recovery of hip joint function between two groups （ P 〉 0.05 ）. And there were two cases with broken nails and cut - out from femoral head in two groups, respectively. Conclusion The PFNA and locking plate were good internal fixation materials for the treatment of proximal femoral fractures.