防旋股骨近端髓内钉与股骨近端锁定钢板治疗股骨转子间骨折疗效比较

Efficacy comparison on intertrochanteric fractures treated by proximal femoral nail antirotation and proximal femoral locking plate

目的比较使用防旋股骨近端髓内钉（PFNA）和股骨近端锁定钢板（PFLP）治疗股骨转子间骨折的疗效。方法对50例股骨转子间骨折患者采用PFNA治疗25例、PFLP治疗25例。观察两组切口长度、手术时间、术中出血量、术中输血量、住院天数、术后引流量、术后Hb下降情况、术后输血量、术后扶拐下地负重时间及骨折愈合时间,按髋关节Harris评分评价两组术后疗效,并进行统计学分析。结果 50例患者均获得随访,时间12～20（18.8±5.6）个月。两组在切口长度、住院天数、术后引流量及骨折愈合时间、髋关节Harris评分各项比较差异均无统计学意义（P〉0.05）;两组在手术时间、术中出血量、术中输血量、术后Hb下降情况、术后输血量及术后下地扶拐负重时间各项比较差异均有统计学意义（P〈0.05）。结论 PFNA及PFLP内固定均是治疗股骨转子间骨折的有效方法。PFLP可明显减少术中、术后输血量;PFNA相对手术时间短、扶拐行走时间早。

Objective To compare the effect of proximal femoral nail antirotation（ PFNA） and proximal femoral locking plate（ PFLP） in the treatment of intertrochanteric fractures. Methods 50 patients with intertrochanteric fractures were treated by PFNA in 25 cases and PELP with 25 cases. Two groups were observed for incision length,operative time,blood loss,intraoperative blood transfusion,hospital stay,postoperative drainage,postoperative Hb decline,postoperative transfusion,postoperative weight bearing and fracture healing time,Harris hip score postoperative evaluation of the efficacy and statistical analysis. Results 50 patients were followed up for 12 ～ 20（ 18. 8 ± 5. 6）months. The two groups in incision length,length of stay,postoperative drainage and healing time,Harris hip score evaluation had no significant difference（ P〉0. 05） on postoperative outcome; But the two groups in operative time,blood loss,intraoperative blood transfusion,postoperative Hb decline,postoperative blood transfusion and postoperative ambulation time on crutches load conditions,comparison results were significant different（ P〈0. 05）. Conclusions PFNA and PFLP fixation methods are effective in the treatment of intertrochanteric fractures,but the PFLP can significantly reduce intraoperative and postoperative blood transfusion,and PFNA relatively short operative time,time to walk with crutches early.