PF-LCP与PFNA治疗高龄股骨粗隆间骨折Evans Ⅲ-Ⅳ型临床对比研究

Clinical comparative study of PF-LCP and PFNA in the treatment of elderly patients with femoral intertrochanteric fractures for Evans Ⅲ-Ⅳ type

目的探讨PF-LCP与PFNA治疗高龄股骨粗隆间骨折Evans Ⅲ-Ⅳ型临床疗效及安全性差异。方法研究对象选取我院2012年4月~2015年4月收治Evans Ⅲ-Ⅳ型高龄股骨粗隆间骨折共110例,以随机区组法分为A组(55例)和B组(55例),分别采用PF-LCP与PFNA术式治疗;比较两组患者围手术期临床指标水平、术后随访髋关节Harris评分及术后并发症发生率等。结果 B组患者手术时间和术中失血量均显著优于A组,差异具有显著性意义(<0.05);两组患者骨折愈合时间和住院时间比较差异无统计学意义(>0.05);B组患者术后随访Harris评分显著高于A组,差异具有显著性意义(<0.05);B组患者术后并发症发生率显著低于A组,差异具有显著性意义(<0.05)。结论 PFNA治疗高龄股骨粗隆间骨折Evans Ⅲ-Ⅳ型可有效缩短手术时间,减少术中创伤,改善术后髋关节功能,且有助于降低术后并发症发生风险,价值优于PF-LCP。

Objective To investigate the clinical effects and safety differences of PF-LCP and PFNA in the treatment of elderly patients with femoral intertrochanteric fractures for Evans III-IV type. Methods 110 elderly patients with femoral femoral intertrochanteric fractures for Evans III-IV type were chosen in the period from Apr 2012 to Apr 2015 in our hospital and randomly divided into both group including A group（55 patients） with PF-LCP and B group（55 patients） with PFNA; and the peri-operative indexes levels, the Harris score of hip after operation with follow-up and postoperative complication incidence of both groups were compared. Results The operative time and intraoperative blood loss of B group was significantly better than A group（P〈0.05）. There was no significant difference in fracture healing time and hospitalization time between 2 groups（P〉0.05）. The Harris score of hip after operation with follow-up of B group was significantly higher than A group（P〈0.05）. The postoperative complication incidence of B group was significantly lower than A group （P〈0.05）. Conclusion Compared with PF-LCP, PFNA in the treatment of elderly patients with femoral intertrochanteric fractures for Evans III-IV type can efficiently shorten the operation time, reduce the intraoperative trauma degree, improve the hip function after operation and be helpful to reduce the risk of postoperative complications.