国产PFNA与股骨近端重建钉治疗老年股骨转子间骨折的疗效对比

A comparative analysis of the domestic-made proximal feoral nail anti-rotation（PFNA） and reconstructive intramedullrey nail for internal fixation the intertrochantetic fracture of femur in elderly with osteoporosis

目的 回顾比较分析应用国产抗旋转股骨近端髓内钉（proximal femoral nails antirotation,PFNA）与股骨近端重建钉治疗老年骨质疏松性股骨转子间骨折的临床疗效.方法 2009年1月-2016年5月应用国产PFNA与股骨近端重建钉治疗65岁以上老年骨质疏松性股骨转子间骨折48例,国产PFNA组23例,国产重建钉组25例.比较两组手术时间、术中出血量、术中X线透视次数、并发症、骨折愈合时间.结果 48例患者均获随访,随访时间为3~18个月,平均12个月.PFNA组的手术时间、术中出血、术后并发症、骨折愈合时间均少于重建钉组,有统计学意义（P〈0.05）.结论 PFNA治疗老年骨质疏松性股骨转子间骨折与重建钉相比较具有操作简单、创伤小、手术时间短、术中出血少、固定稳固、骨折愈合较早等优点,较重建钉具有更好的临床疗效,值得临床推广应用.

Objective To comparatively analyze the clinical results of the domestic-made proximal femoral nails antirotation （PFNA） and reconstructive intramedullary nail for internal fixation the intertrochantetic fractures of femur in the elderly with osteoporosis. Methods A total of 48 osteoporotic intertrochanteric fractures were treated from January 2009 to May 2016. They were over 65 years old, and were treated with the proximal femoral nails anti-rotation （PFNA group） and reconstructive intramedullary nail（Recon Nail group）, 23 in PFNA group and 25 in Recon Nail group. The patients were followed up respectively. The operative time, the blood-loss in operation, the number of using X-Ray during the operation, the complications and the outcomes of the fracture union were compared. Results All the 48 cases were followed up from 3 to 18 months, （average 12 months）. The blood-loss in operation, the operative time, the number of using X-Ray during the operation, the complications and the outcomes of the fracture union were less in the patients using the PFNA, and there are significant differences in the comparation. Conclusion Internal fixation with PFNA in the elderly with osteoporosis bears the advantages of simple operation, minimal injury to the patients, less operation time, less bleeding, reliable fixation. The patients were permitted to have function recovery earlier. PFNA is an ideal method for internal fixation of the intertrochanteric fractures of femur in the elderly with osteoporosis.