应用PFNA和InterTan系统治疗高龄股骨转子间骨折的效果对比

Efficacy comparison of PFNA and Inter Tan system in the treatment of senile intertrochanteric fractures

【目的】比较应用防旋股骨近端髓内钉（proximal femoral nail antirotation,PFNA）和Inter Tan系统治疗高龄股骨转子间骨折的临床疗效。【方法】对2011年5月至2014年5月50例高龄股骨转子间骨折患者进行回顾性分析,骨折类型均为EvansⅣ型,分别使用PFNA和Inter Tan系统内固定,详细记录切口长度、手术时间、术中失血量,住院时间、围手术期并发症、骨折愈合时间及完全负重时间,随访采用Harris评分标准对结果进行评估。【结果】所有患者获得7～24个月随访。骨折全部愈合,愈合时间为15～21周,平均17周,无切口感染、深静脉血栓、骨折延迟愈合或不愈合等并发症发生。手术时间及术中出血量PFNA组较Inter Tan组少（P〈0.05）,两组在切口长度、骨折愈合时间及术后3个月大腿疼痛程度和术后髋关节功能均无明显差异（P〉0.05）。【结论】PFNA和Inter Tan系统两种内固定系统设计合理,均具有出血少、内固定牢固、减少围手术期并发症等优点,但又各有优势。PFNA操作相对简便,组织损伤更小,Inter Tan系统理论上具有更高的稳定性,两种内固定方法均具有很好的应用前景。

【Objective】To compare the clinical efficacy of proximal femoral nail antirotation（PFNA） and Inter Tan system in the treatment of senile intertrochanteric fractures.【Methods】The data of 50 cases with senile intertrochanteric fractures were retrospectively analyzed from May 2011 to May 2014. The,fracture types were all Evans IV. PFNA and Inter Tan system were used respectively for internal fixation. The length of incision, operation time, operative blood loss, hospitalization time, perioperative complications, fracture healing time and full load time were recorded in detail. The results were evaluated via Harris score.【Result】All patients were followed up for 7-24 months. All fractures healed. The healing time was 15-21 weeks and in an average of 17 weeks. There were no complications such as incision infection, deep vein thrombosis, delayed union or nonunion, et al. The operation time and operative blood loss in PFNA group were less than those in Inter Tan group（P〈0.05）. There was no difference in incision length, fracture healing time, thigh pain in 3months after the operation and postoperative hip function（P〉0.05）.【Conclusion】PFNA and Inter Tan system, two kinds of internal fixation, are designed reasonably. They are of less bleeding, tight internal fixation and less perioperative complications, et al. However each of them has its own advantages. As for PFNA, the operation is relatively easy; the tissue damage is less. Inter Tan system is of higher stability in theory. In a word, both of internal fixation methods have good application prospect.