股骨近端锁定钢板与防旋髓内钉治疗稳定型股骨转子间骨折的疗效分析

Efficacy comparison between proximal femoral nail antirotation and proximal femoral locking plate for stable intertrochanteric fracture

目的比较股骨近端锁定钢板(PFLP)与股骨近端防旋髓内钉(PFNA)治疗稳定型(Evans分型1组及Ⅰ型2组)股骨转子间骨折的疗效。方法回顾性分析2014年12月—2017年1月安徽省第二人民医院收治的36例稳定型股骨转子间骨折患者,按手术方法不同分为PFLP组(21例)和PFNA组(15例),记录并比较两组手术时间、出血量、术后恢复时间以及髋关节功能。结果 36例患者均获得随访,时间3~18个月,两组手术时间、术后住院时间差异无统计学意义(P>0.05)。两组均获得骨折愈合,PFNA组骨折愈合时间、术后下地负重时间短于PFLP组[(10.80±2.93)周vs.(15.14±2.10)周、(5.33±3.24)周vs.(8.38±2.62)周],差异有统计学意义(P<0.01),术中出血量PFNA组少于PFLP组[(206.67±62.18)m L vs.(296.67±98.96)m L],差异有统计学意义(P<0.01)。两组术后3个月髋关节功能评分,优良率均达70%以上,差异无统计学意义(P>0.05)。两组术后没有严重并发症出现。结论 PFNA与PFLP均是稳定型转子间骨折的优秀内固定选择,但PFNA术中出血较少,术后恢复更快,更适用于稳定股骨转子间骨折。

Objective To compare the clinical efficacy of proximal femoral nail antirotation（ PFNA） and proximal femoral locking plate （ PFLP） in the treatment of stable intertrochanteric fracture （ Evans type I group1 and type I group2） . Methods Thirty-six patients with stable intertrochanteric fracture in our hospital fromDec. 2014 to Jan. 2017 were divided into PFNA group（ n = 15 ） and PFLP group（ n = 21） according to diferent operation metli- ods. The operating time,blood loss,recovery time and hip function after the operation were recorded and compared.Results All the 36 patents were followed up for 3 to 18 months. The average operating time and hospital stay hadno statistical differencc between the two groups （P 〉 0. 0 5 ） . The bone union had been achieved in both groups. But the average time of bone union and weight-bearing was shorter in PFNA group than that statistical differences（P 〈0. 0 1 ） . Also,the amount of intraoperative blood loss was much more in PFLP group than that in PFNA group,and the diference was statistically significant（ P 〈0. 0 1 ） . The excellent rate of hip function a - ter operation reached above 70% in both groups, which had no statistical differencc （P 〉 0. 05 ） . No severe compli-cation was observed in eithier group. Conclusion PFNA and PFLP are excellent internal fixations for stable inter-trochanteric fracture. Because of less blood loss and faster postoperative recovery during operationsuitable for stable intertrochanteric fractures.