股骨近端防旋髓内钉与解剖型锁定钢板治疗老年不稳定型股骨转子间骨折疗效比较

Comparison of proximal femoral nail antirotation and anatomical locking compression plate in the treatment of elder patients with unstable intertrochanteric fractures

目的：比较股骨近端防旋髓内钉（PFNA）与解剖型锁定钢板（ALP）治疗老年不稳定型股骨转子间骨折的临床疗效。方法选取92例老年不稳定型股骨转子间骨折的患者，按随机数法分为PFNA组（46例）和ALP组（46例），分别采用PFNA内固定与ALP内固定。对比分析两组患者术中一般情况、术后恢复情况及并发症的发生情况。结果手术时间、术中出血及术后引流量PFNA组均明显少于ALP组（t＝20．099、3．111、2．864，P＝0.000、0.003、0.005）。92例均获随访，时间4～7个月。骨折愈合时间及术后髋关节功能评分两组比较差异均无统计学意义（t＝0.499、0.674，P＝0.619、0.502）。并发症发生率两组比较差异无统计学意义（2.2％ vs 4.3％，χ2＝0.345，P＝0.557）。结论 PFNA与ALP在老年不稳定型股骨转子间骨折治疗中的临床疗效相当，但PFNA所造成的损伤较小，更有利于术后患者的恢复。

Objective To compare the effect of proximal femoral nail antirotation（PFNA）and anatomical locking compression plate （ALP）in the treatment of elder patients with unstable intertrochanteric fracture.Methods 92 pa-tients with unstable intertrochanteric fracture were randomly divided into the PFNA group and the ALP group.There were 46 patients in each group.Compared with general situation during the surgery,postoperative recovery and com-plications between the two groups.Results Operative time,blood loss and postoperative drainage volume of the PF-NA group was significantly less than that of the ALP group （t=20.099,3.111,2.864,P=0.000,0.003,0.005）.All patients were followed up for 4-7 months,the difference of fracture healing time,postoperative hip score and rate of occurrence of complications were not statistically significant （t=0.499,0.674,P=0.619,0.502）.The difference between the two groups in incidence of postoperative complications was not statistically significant （2.2% vs 4.3%,χ2 =0.345,P=0.557）.Conclusions The effect of PFNA and ALP in treating elder patients with unstable intertro-chanteric fracture is similar,but PFNA causes less damage,which is worth promoting.