股骨近端防旋髓内钉与解剖型定板治疗老年股骨粗隆间骨折的疗效比较

Comparison of Proximal Femoral Nail and Anatomical Plate for the Treatment of Intertrochanteric Fracture in Elderly Patients

目的对比分析股骨近端防旋髓内钉与解剖型定板治疗老年股骨粗隆间骨折的临床疗效。方法选取2010年10月—2014年9月该院收治的老年股骨粗隆间骨折患者86例,按照数字表法随机分为两组,每组43例,观察组给予股骨近端防旋髓内钉(PFNA)治疗,对照组行解剖型锁定钢板治疗(ALP),对比分析两组患者术中情况、髋关节评分以及术后并发症发生情况。结果观察组患者手术时间及术中出血量分别为(103.36±15.69)min、(252.27±20.61)m L,对照组分别为(124.08±14.02)min、(326.03±19.62)m L,观察组患者手术时间、术中出血量明显优于对照组,两组比较差异有统计学意义(P<0.05);观察组患者髋关节功能评分优良率为95.35%,对照组为81.40%,观察组髋关节功能评分优良率高于对照组,差异有统计学意义(χ2=4.07,P<0.05);观察组并发症发生率低于对照组,但是组间比较差异无统计学意义(P>0.05)。结论 PFNA治疗老年股骨粗隆间骨折手术创伤小,术后并发症少且利于患者髋关节功能恢复,是治疗股骨粗隆间骨折的首选方法,值得进一步推广应用。

Objective Comparative analysis of proximal femoral nail anti rotation intramedullary nail and anatomical plate in the treatment of elderly patients with intertrochanteric fractures of the clinical efficacy. Methods We selected86 cases of elderly patients with intertrochanteric fracture, were randomly divided into two groups, 43 cases in each group, the observation group was treated with proximal femoral nail anti rotation intramedullary nail treatment, the control group was given anatomical locking plate treatment, The operation condition,hip score and the incidence of postoperative complications were compared between the two groups. Results The operation time and blood loss of the observation group were（103.36±15.69） min,（252.27±20.61） m L; The operation time and blood loss of the control group were（124.08 ±14.02） min,（326.03 ±19.62） m L.Observation group patients with operation time, intraoperative bleeding was significantly higher than that of the control group, the difference between the two groups has statistical significance（P 〈0.05）; The excellent rate of hip function score was 95.35% in the observation group and 81.40% in the control group,observation group hip function score, the excellent and good rate was higher than the control group, the difference is statistically significant（χ2=4.07, P〈 0.05）; observation group, the complication rate was lower than the control group,but between groups differences no statistical significance（P〉 0.05）. Conclusion PFNA treatment of elderly patients with intertrochanteric fracture of the surgical trauma is small, less postoperative complications and conducive to the recovery of hip function in patients, is the treatment of intertrochanteric fracture of the preferred method, it is worth further promotion and application.