股骨近端防旋髓内钉在股骨转子间骨折老年患者中的效果研究

Research on clinical effects of PFNA-Ⅱ in treating elderly patients with femoral intertrochanteric fracture

目的比较亚洲型股骨近端防旋髓内钉(PFNA-Ⅱ)与传统股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的临床疗效。方法回顾性分析2010年2月至2014年1月该院收治的行PFNA-Ⅱ与PFNA治疗的89例股骨转子间骨折老年患者临床资料,根据患者手术方式的不同分为两组,其中PFNA-Ⅱ组48例,PFNA组41例。记录并比较两组患者术中情况、骨折愈合情况、随访12个月时Harris评分优良率及术后并发症发生情况。结果 PFNA-Ⅱ组患者手术时间、术中透视时间均短于PFNA组,PFNA-Ⅱ组术中出血量显著少于PFNA组,差异均有统计学意义(P<0.05);两组患者部分负重时间、完全负重时间、骨折愈合时间及Harris评分优良率比较差异均无统计学意义(P>0.05);PFNA-Ⅱ组大腿隐痛发生率显著低于PFNA组,差异有统计学意义(χ~2=14.490,P<0.05)。结论 PFNA-Ⅱ与PFNA比较,其手术创伤小,操作简便,疗效无差异,且能有效减少大腿隐痛的发生率,值得临床进一步研究。

Objective To compare the clinical effects of PFNA-Ⅱand traditional PFNA in the treatment of elderly patients with femoral intertrochanteric fracture.Methods The clinical data in 89 elderly patients with femoral intertrochanteric fracture in our hospital from February 2010 to January 2014 were retrospectively analyzed.The patients were divided into 2 groups according to the surgical modes,including the PFNA-Ⅱgroup（48cases）and PFNA group（41cases）.The intraoperative conditions,fracture healing,Harris score at 12-month follow up and the incidence of postoperative complications were recorded and compared between the two groups.Results The operative time and intraoperative fluoroscopy time in the PFNA-Ⅱgroup were shorter than those in the PFNA group;intraoperative blood loss was significantly less than that in the PFNA group（P〈0.05）;the partial weight bearing time,full weight bearing time,fracture healing time and Harris score excellent rate showed no statistically significant difference between the two groups（P〉0.05）;the incidence of thigh dull pain the PFNA-Ⅱ group was significantly lower than that in the PFNA group,the difference was statistically significant（χ^2=14.490,P〈0.05）.Conclusion PFNA-Ⅱ has less trauma,simple operation,no difference in efficacy,can effectively reduce the incidence of thigh dull pain compared with PFNA,and is worth further study in clinical.