经皮加压钢板与防旋股骨近端髓内钉固定治疗老年股骨粗隆间骨折临床对比研究

Clinical analysis of PCCP and PFNA fixation in the treatment of intertrochanteric fracture of femur on the elderly

目的比较经皮加压钢板(percutaneous compression plate,PCCP)和防旋股骨近端髓内钉(proximal femoral nail anti-rotation,PFNA)固定治疗老年股骨粗隆间骨折的临床效果。方法选取安徽省妇幼保健院2015年8月至2016年8月接诊的82例老年股骨粗隆间骨折患者为研究对象,根据治疗方法不同将其分为PCCP组和PFNA组,每组各41例。比较两组患者手术相关指标、骨折融合时间、并发症发生率及髋关节功能恢复情况。结果两组患者手术用时比较无显著差异(P>0.05);PFNA组患者X线暴露时间和骨折融合时间均显著短于PCCP组(P<0.05),术中出血量多于PCCP组(P<0.05)。与术前(T_1)相比,两组患者术后1周(T_2)、术后2个月(T_3)及术后6个月(T_4)的Harris髋关节功能评分均逐渐升高(P<0.05),且PFNA组患者T_3、T_4时间点Harris髋关节功能评分均明显高于PCCP组(P<0.05)。两组患者各并发症发生率比较均无显著差异(P>0.05)。结论PFNA与PCCP治疗老年股骨粗隆间骨折效果相当,PFNA恢复速度快,PCCP出血量少,临床医师应根据患者具体情况合理选择治疗方式。

Objective To compare the clinical effects of percutaneous compression plate （PCCP） and proximal femoral nail anti-rotation （PFNA） in the treatment of intertrochanteric fracture of femur on the elderly. Method 82 elderly patients with intertrochanteric fracture of femur in Anhui Maternal and Child Health Care Hospital from August 2015 to August 2016 were selected as the research objects, according to the different treatment methods, they were divided into PCCP group and PFNA group, 41 cases in each group. The operation related indexes, fracture fusion time, complication rate and the recovery of hip function were compared between the two groups. Result There was no significant difference in the operation time between the two groups （P 〉 0.05）. The X-ray exposure time and fracture fusion time in PFNA group were shorter than that in PCCP group （P 〈 0.05）, andintraoperative blood loss was more than those in PCCP group （P 〈 0.05）. Compared with before operation （T1）, the Harris hip function scores of the two groups at 1 week after operation （T2）, 2 months after operation （T3） and 6 months after operation （T4） were gradually increased （P 〈 0.05）, and the scores of T3 and T4 time points in PFNA group were higher than those in PCCP group （P 〈 0.05）. There was no significant difference in the incidence rate of complications between the two groups （P 〉 0.05）. Conclusion PFNA and PCCP have the same effect in the treatment of intertrochanteric fracture of femur in elderly patients. The rate of recovery of PFNA is faster and the amount of bleeding of PCCP is less. Doctor should select the reasonable therapy according to the specific conditions of the patient.