髓内钉与锁定钢板内固定治疗老年股骨粗隆间骨折比较

目的比较防旋股骨近端髓内钉（PFNA）与股骨近端锁定钢板（LPFP）治疗老年股骨粗隆间骨折的疗效。方法老年人股骨粗隆间骨折42例，行PFNA治疗23例（骨折按Evans分型Ⅱ型7例、Ⅲ型9例、Ⅳ型7例），行LPEP治疗19例（Evans分型I型3例、Ⅱ型8例、Ⅲ型3例、Ⅳ型5例）。术后1个月、3个月、6个月X线复查。结果参照Harris髋关节功能评分标准，PFNA组优良率95．6％，LPEP组优良率94．7％，差异无统计学意义。结论LPFP系统与PFNA系统治疗老年股骨粗隆间骨折均能取得较好的疗效，但从力学角度分析，由于髓内钉系统力臂短，固定更为稳固。

Objective Analyzed anti spin proximal femoral intramedullary nail （ proximal femoral nail antirotation, PFNA ） , proximal femoral locking plate （ LPFP ） the curative effect of treatment of intertrochanteric fracture. Methods Our hospital from December 2007 to January 2009 a total of stuffs in the trochanteric fractures 42 cases, men and women, 27 cases, in 15 cases. Age 62-90-year-old, an average of 72.8 years old. Fracture classification by Evans, PFNA 23 cases： the treatment 8 cases of type II, type III 9 cases, type 1V 7 cases; LPEP 19 cases： the treatment of 3 cases of type I , 8 cases of type II, type III 3 cases, IV 5 cases. Postoperative follow-up and after 1 month, 3 months, 6 months x-ray review. Results Reference Harris hip scoring criteria, PFNA group patients rate of 95.6%; LPEP group rate of 94.7%. Two sets of data to u （ u=2.045, -P〉0.05 ） , PFNA group curative effect of treatment of intertrochanteric fracture with LPEP group there was no statistically significant differences. Conclusion Through observation, intramedullary nail system （ PFNA ） and proximal femur anatomic locking plate screw system （ LPFP ） treatment of intertrochanteric fracture can obtain good effect.