PFNA与半髋置换治疗老年股骨转子间骨折的临床研究

A Study on Proximal Femoral Nail Antirotation Versus Hemiarthroplasty in the Teatment of Intertrochanteric Fractures for Elderly Patients

目的:探讨PFNA与半髋置换治疗老年股骨转子间骨折的临床疗效。方法:将96例股骨转子间骨折老年患者随机分为PFNA内固定组和半髋置换组,均为48例。PFNA内固定材料选用AOPFNA内固定系统,半髋置换选用史赛克公司人工股骨头翻修假体。结果:两组术中出血量、手术时间和术后18个月Harris评分均有差异(P<0.05),PFNA内固定组术中出血较少,手术时间较短,半髋置换组术中出血较多,手术时间较长,术后18个月Harris评分PFNA内固定组高于半髋置换组。两组住院时间无差异(P>0.05)。结论:PFNA内固定组治疗老年股骨转子间骨折较半髋置换组手术时间短,术中出血少,疗效满意。

Objective： To study the effects of proximal femoral nail antirotation and hemiarthroplasty on intertrochanteric fractures. Methods： A retrospective study was performed in our institution,and 48 patients were treated with proximal femoral nail antirotation,and the rest underwent hemiarthroplasty. Inrermal fixators system of AO Company was used for the fixator of PFNA and the artificial thign bone of Stryker Company was used for hemiarthroplasty. Results： There were statistically significant difference between two groups in the operative parameters,especially the blood loss,operation time,and the Harris Hip Scores at 18 months after operation（ P〈0. 05）. Compared to the group of PFNA,the group of hemiarthroplasty experienced longer time,more blood lost,and worse Harris Hip Scores. There was no significant difference in hospital stays（ P〉0. 05）. Conclusion： For elderly patients with intertrochanteric fractures,PFNA was superior to hemiarthroplasty,demonstrated by shorter operation time,less bleeding,and better therapeutic effect.