微创锁定钢板内固定与PFNA内固定治疗粗隆间骨折的预后对比分析

The prognosis comparison of minimally invasive locking plate fixation and intertrochanteric fractures PFNA for treating intertrochanteric fractures

目的对比微创锁定钢板内固定与PFNA(股骨近端抗旋髓内钉)内固定治疗粗隆间骨折的预后。方法老年股骨粗隆间骨折患者120例,根据入院顺序分为治疗组与对照组各60例,对照组给予股骨近端抗旋髓内钉(PFNA)内固定治疗,治疗组:给予微创锁定钢板内固定治疗。结果两组的手术时间与骨折愈合时间对比差异无统计学意义(P>0.05),治疗组的术中出血量、切口长度和术后住院天数明显少于对照组(P<0.05)。随访3个月,治疗组的髋关节优良率为90.0%,对照组为76.7%,组间对比差异有统计学意义(P<0.05)。治疗组的髋关节活动度与髋关节Harris评分明显高于对照组(P<0.05)。治疗组的髋内翻、褥疮、深静脉血栓形成等并发症总发生率明显少于对照组(P<0.05)。结论相对于PFNA内固定,微创锁定钢板内固定在老年股骨粗隆间骨折中的应用能更加恢复患者的关节功能,创伤少,安全性好,值得推广应用。

Objective To compare the prognosis of minimally invasive locking plate fixation and intertrochanteric fractures PFNA for treating intertrochanteric fractures. Methods 120 elderly hospitalized patients with intertrochanteric fractures were equally divided into treatment group and control group,the control group were given anti- spin proximal femoral nail（ PFNA） fixation,the treatment group were given minimally invasive locked plate fixation. Results The operative time and fracture healing time between the two groups compared had no significant difference（ P〈0. 05）,but the amount of bleeding,incision length and postoperative hospital stay time of the treatment group were significantly less than the control group（ P〈0. 05）. Followed up 3-month,the excellent hip between the groups were 90. 0 % and 76. 7% that compared to the difference had statistically significant（ P〈0. 05）. The hip ctivity and hip Harris scores of the treatment group were significantly higher（ P〈0. 05）. the overall incidence of complications of hip turn,pressure ulcers,deep vein thrombosis of the treatment group were significantly less than the control group（ P〈0. 05）. Conclusion Compared to the PFNA fixation,minimally invasive locking plate fixation for treating intertrochanteric fractures elderly patients can be more restore joint function with less trauma,it has safety and should be widely applied.