股骨近端防旋转髓内钉治疗不稳定股骨粗隆间骨折的研究

Curative Effects on Unstable Femoral Intertrochanteric Fracture with Proximal Femoral Nail Antirotation

目的:探讨股骨近端防旋转髓内钉(PFNA)内固定治疗不稳定股骨粗隆间骨折的临床疗效。方法:选取2012年4月至2014年1月间收治的不稳定型股骨粗隆间骨折患者66例,随机分为观察组与对照组,观察组患者采用PFNA内固定治疗,对照组采用股骨近端解剖型锁定钢板(ALP)内固定治疗,对比两组患者术中、术后情况及骨折愈合时间,并对患者进行1年回访,观察其髋关节功能Harris评分改善情况。结果:观察组患者手术时间、术出血量、术后引流量及下地负重时间均显著优于对照组(P<0.05);术后1年回访,观察组髋关节功能Harris评分优良率为94.7%,对照组为92.9%,两组间比较无统计学差异(P>0.05)。结论:PFNA治疗不稳定股骨粗隆间骨折效果显著,且创伤小、操作简单、固定可靠,患者术后可早期进行功能康复训练,对年龄较大、不能耐受较长时间手术、身体状况较差的患者,应优先考虑使用。

Objective：To investigate the clinical efficacy of unstable femoral intertrochanteric fracture with proximal femoral nail antirotation （ PFNA） .Method：66 unstable femoral intertrochanteric fracture pa-tients admitted by our hospital from Apr .2012 to Jan.2014 were enrolled in our study and were divided into the observation group and the control group .The patients in the observation group were treated by PFNA , and the proximal femoral anatomic locking plate （ ALP ） was used in treating the patients in the control group .The intraoperative and postoperative conditions and the fracture healing time of the patients in the two groups were compared.Meanwhile, the patients were received a one-year return visit.The situation of Harriship joint function score improved was observed.Result： The operation time, peri-operative blood loss, postoperativesunction drainage, and the underground load time in the patients of the observation group were sig -nificantly superior to those in the control group （P〈0.05）.The postoperative one-year return visit showedthat the excellent and good rate of Harris hip joint function score was 94.7%, while that in the control groupwas 92.9%.There were no significant differences between the two groups （P〉0.05）.Conclusion： The efficacyof PFNA in treating unstable femoral intertrochanteric fracture patients is obvious .Meanwhile, PFNAhas the advantages of little trauma, easy for operating, and a reliable fixation.After operation, the patientscan make an early functional rehabilitaion training.To those who are old, unable to endure the long-time operation,and have bad physical conditions, PFNA should be adopted in preference.