防旋型股骨近端髓内钉-Ⅱ与人工关节置换治疗老年性股骨粗隆间骨折的疗效分析

Evaluation of therapeutic results of hip arthroplasty and proximal femoral nail antirotation- Ⅱ for elderly femoral intertrochanteric fractures

目的 比较人工关节置换与防旋型股骨近端髓内钉-Ⅱ（PFNA-Ⅱ）内固定治疗老年性股骨粗隆间骨折的临床疗效.方法 对35例行人工关节置换与44例行PFNA-Ⅱ固定手术的老年性股骨粗隆间骨折患者的平均手术时间、术中出血量、早期并发症及髋关节功能的进行比较分析.结果 人工关节组平均手术时间、术中出血量及术后早期并发症发生率均高于PFNA-Ⅱ组;术后3个月髋关节功能评分差异无统计学意义,术后9个月PFNA-Ⅱ组要优于人工关节组.结论 PFNA-Ⅱ内固定治疗老年性股骨粗隆间骨折更具优势.

Objective To compare the therapeutic results of hip arthroplasty and proximal femo-ral nail antirotation-Ⅱ （ PFNA- Ⅱ ） for elderly femoral intertrochanteric fractures. Methods A retrospec-tive study on elderly intertorchanteric fractures was performed ,including 35 cases of hip arthoplasty and g4 cases of internal fixation with PFNA-Ⅱ. Operation duration, intraoperative blood loss, early complication and hip function were compared and analyzed. Results The operation duration, intraoperative blood loss and early complication rate of arthroplasty group was higher than that of the PFNA-Ⅱ group. The difference in hip function at the 3rd month between the groups was not significant. The hip function at the 9th month in PFNA- Ⅱ group achieved better outcome than that in the arthroplasty group. Conclusion Internal fixa-tion with PFNA- Ⅱ is especially suitable for elderly patient with femoral interachanteric fractures.