PFNA内固定用于老年股骨粗隆间骨折中的可行性及安全性

Feasibility and safety of PFNA internal fixation treatment of senile intertrochanteric fracture

目的探究PFNA内固定用于老年股骨粗隆间骨折中的可行性和安全性。方法选取我院2012年1月~2015年2月收治的100例股骨粗隆间骨折老年患者,随机分为两组。其中对照组48例,采用DHS内固定系统;试验组52例,采用PFNA内固定系统,比较两组术中手术指标,术后临床疗效和并发症等情况。结果试验组手术时间（44.8±7.8）min、术中出血量（98±24）m L、负重时间（5.8±2.4）周、骨折愈合时间（11.4±2.4）周都明显小于对照组（55.1±6.4）min、（164±28）m L、（7.2±1.6）周、（13.5±4.8）周（P〈0.05）。试验组的治疗总有效率（90.38%）大于对照组（72.92%）（P〈0.05）。试验组的并发症率（7.7%）明显小于对照组（25.0%）（P〈0.05）。结论 PFNA内固定用于老年股骨粗隆间骨折中的临床疗效好,可行性和安全性高,值得临床推广。

Objective To study the feasibility and safety of PFNA（proximal femoral nail antirotation） internal fixation in the treatment of senile intertrochanteric fracture. Methods 100 elderly patients with intertrochanteric fracture, who were selected in our hospital from January 2012 to February 2015, were randomly divided into two groups. 100 elderly patients with intertrochanteric fracture, who were selected in our hospital from January 2012 to Februry 2015, were randomly divided into two groups. 48 patients in control group were treated with DHS（dynamic hip screw） internal fixation system, and 52 patients in experimental group were treated with PFNA internal fixation system. To compare the intraoperative operation indices, postoperative clinical effect, and complication condition and so on between the two groups. Results The intraoperative operation time, the intraoperative blood loss, the weight bearing time, and the fracture healing time in experimental group[（44.8±7.8）min,（98±24）m L,（5.8±2.4）weeks,（11.4±2.4）weeks] were obviously less than which in control group[（55.1±6.4）min,（164±28）m L,（7.2±1.6）weeks,（13.5±4.8）weeks]（P〈0.05）. The treatment total effective rate in experimental group（90.38%） was higher than which in control group（72.92%）（P〈0.05）, the complication rate in experimental group（7.7%） was obviously less than which in control group（25.0%）（P〈0.05）. Conclusion PFNA internal fixation in the treatment of senile intertrochanteric fracture has better clinical effect, has higher of feasibility and safety, is worthy of clinical popularization.