股骨近端防旋髓内钉内固定治疗老年股骨转子间骨折的价值

Clinical value of proximal femoral nail anti-rotation internal fixation in the treatment of intertrochanteric fracture

目的对比股骨近端防旋髓内钉（PFNA）、股骨近端髓内钉（PFN）两种内固定术对老年股骨转子间骨折的手术效果及应用价值。方法本院2009年1月～2011年2月收治76例老年股骨转子间骨折患者，随机分为PFNA组和PFN组各38例，PFNA组予以股骨近端防旋髓内钉内固定治疗，PFN组均接受股骨近端髓内钉治疗，对比两组的手术效果及髋关节功能Sanders评分情况。结果PFNA组手术时间、术中失血量、平均住院时间均少于PFN组（P〈0．05）；两组的并发症发生率无显著性差异（P〉0．05）；PFN组髋关节功能评分优良率显著低于PFNA组（P〈0．05）。结论PFNA治疗老年股骨转子间骨折具有创伤小、术后恢复好的优势，具有推广价值。

Objective To compare clinical effects and values of proximal femoral nail anti-rotation and proximal femoral nail internal fixation in the treatment of intertrochanteric fracture. Methods A total of 76 elderly patients with intertrochanteric fractures from January 2009 to February 2011 were divided into PFNA group and PFN group with 38 cases in each. The PFNA group took proximal femoral nail anti-rotation internal fixation and the PFN group took proxi- mal femoral nail internal fixation. The surgical results and sanders scores were compared. Results The operative time, blood loss and hospitalization time of the PFNA group were significantly shorter than that of the PFN group （P〈0.05）. The incidence of complications of both groups has no significant difference （P〈0.05）. Excellent rate of sanders scores in the PFN group was significantly lower than PFNA group （P〈0.05）. Conclusion PFNA has advantage of minimally inva- sire and promote postoperative recovery. PFNA has promotional value in the treatment of intertrochanteric fracture.