防旋型股骨近端髓内钉治疗不同年龄段老年人股骨转子间骨折疗效比较

A comparison of different ages in the minimally invasive treatment of intertrochanteric fractures of the elderly by proximal femoral nail antirotation

目的 探讨防旋型股骨近端髓内钉（PFNA）治疗不同年龄段老年人股骨转子间骨折的临床疗效.方法 对60例老年股骨转子间骨折患者采用PFNA治疗,按照年龄分成3组（每组20例）：A组（60～69岁）,B组（70～79岁）,C组（80～89岁）.对各组的手术时间、出血量、住院天数、临床愈合时间、术后并发症及髋关节功能进行比较.结果 60例均获随访,时间11～15（13±1.5）个月.3组间临床愈合时间、术后并发症比较差异均有统计学意义（P＜0.05）;3组间手术时间、出血量、住院天数、术后Harris评分比较差异均无统计学意义（P＞0.05）.结论 PFNA 治疗老年股骨转子间骨折具有手术时间短、创伤少、术中出血量少等优点.老年患者年龄越大骨折愈合时间越长,术后并发症越多.

Objective To discuss the clinical results of intertrochanteric fractures of the elderly using proxilnal femo-ral nail antirotation （PFNA） in different ages. Methods 60 patients with intertrochanteric fractures were treated by PFNA according to the age into three groups： group A （60 ～69 years） , group B （70 ～79 years） , group C （80 ～89 years） ; 20 cases in each group. The operative tilne, bleeding volume,hospitalization days,fracture healing time and postoperative functional recovery,postoperative complications were compared. Results All the patients were followed up for 11～ 15 （ 13 ± 1.5） months. There were significant differences alnong the three groups in fracture healing time and postoperative complications（P 〈 0. 05）. There were no algnificant differences alnong the three groups in operative tilne,bleeding volume,hospitalization days, and postoperative functional recovery（P 〉0.05）. Conclusions The treatment of intertrochanteric fractures of the elderly by PFNA has many advantages ,such as minilnally invasion,less bleeding,less operative time. The older the age, the longer the healing time, the more postoperative complications.