PFNA治疗老年股骨粗隆间骨折的治疗体会

PFNA in the treatment of senile intertrochanteric fracture

目的 探讨股骨近端防旋髓内钉（proximal femoral nail antirotation,PFNA）治疗老年股骨粗隆间骨折的临床效果.方法 选择2013年1月至2014年12月来我院就诊的70例股骨粗隆间骨折的老年患者作为研究对象,利用随机数字表法将其分为观察组和对照组,观察组35例采用PFNA内固定治疗,对照组35例采用动力髋螺钉（dynamic hip screw,DHS）内固定治疗.观察比较两组患者的手术时间、出血量以及术后髋关节功能评分.结果 观察组患者平均手术时间与出血量均少于对照组[（62.4±17.6） min vs.（84.3±28.5） min,（121±21） mlvs.（296±39） ml],差异均有统计学意义（P＜0.05）.观察组术后髋关节Harris评分优良率为91.43％,高于对照组的74.29％,差异有统计学意义（P＜0.05）.结论 PFNA治疗老年股骨粗隆间骨折具有手术时间短、出血量少、恢复快、疗效好的特点,值得临床上推广应用.

Objective To investigate the clinical effect of proximal femoral nail anti-rotation （PFNA） in the treatment of senile intertrochanteric fracture.Methods 70 cases of senile intertrochanteric fracture in our hospital from January 2013 to December 2014 were selected as research subjects, divided into observation group and control group according to random number table.35 cases in observation group received PFNA fixation treatment, while 35 cases in control group received dynamic hip screw （DHS） internal fixation.Observed operative time, blood loss and postoperative hip function score of two groups.Results The average operative time and blood loss in observation group were both less than those in control group [（62.4±17.6）min vs.（84.3±28.5）min, （121±21）ml vs.（296±39）ml], with statistically significant differences between two groups （P〈0.05）.The excellent and good rate of postoperative Harris hip score in observation group was 91.43%, significantly higher than 74.29% in control group, with statistically significant difference between two groups （P〈0.05）.Conclusion PFNA has advantages such as shorter operative time, less blood loss, faster recovery and good efficacy in the treatment of senile intertrochanteric fracture, should be widely applied clinically.