股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的疗效分析

Analysis of proximal femoral anti-rotation nail in the treatment of intertrochanteric fractures in the elderly

目的研究闭合复位股骨近端防旋髓内钉(PFNA)内固定和人工股骨头置换术(FHR)治疗老年股骨粗隆间骨折的临床疗效。方法将87例老年股骨粗隆间骨折患者分为闭合复位PFNA内固定治疗组(A组,46例)和FHR治疗组(B组,41例),记录两组手术时间、术中出血量、术后引流量、住院天数及Harris髋关节评分的变化。结果 87例患者随访12-28个月。与B组相比,A组手术时间、术中出血量、术后引流量和住院天数减少(P<0.01);而两组Harris髋关节评分无统计学差异(P>0.05)。结论 PFNA内固定在治疗老年股骨粗隆间骨折的临床效果优于FHR的治疗效果。

Objective To investigate the clinical efficacy of proximal femoral nail anti-rotation（PFNA）internal fixation and femoral head replacement（FHR）in the treatment of intertrochanteric fractures in the elderly.Methods A total of 87 elderly patients with intertrochanteric fractures was randomized into two groups of A（treated by PFNA internal fixation,46cases）and B（treated by FHR,41cases）.The operative time,intraoperative blood loss,postoperative drainage,hospital stay and Harris hip score were compared between two groups.Results Eighty-seven patients were followed up for 12 to 18 months.Compared with group B,the operative time,intraoperative blood loss,postoperative drainage and hospital stay were decreased in group A（P〈0.01）.However,there was no significant difference in Harris hip score between groups of A and B（P〉0.05）.Conclusion Internal fixation of intertrochanteric fractures with PFNA in the elderly achieves a better result than FHR.