PFNA内固定与人工髋关节置换术治疗骨质疏松性粗隆间骨折的临床效果对比

Efficacy of Proximal Femoral Nail Anti-rotation and Artificial Hip Replale ment on Osteoporotic Intertrochanteric Fracture

目的:观察股骨近端髓内钉(PFNA)内固定及人工髋关节置换术(HA)治疗的骨质疏松性粗隆间骨折(IFF)的临床效果。方法:回顾性分析67例于笔者所在医院治疗的骨质疏松性IFF患者的临床资料,按手术方式分为P组(33例,行PNFA)和H组(34例,行HA),观察比较患者手术操作时间、术中出血量、术后下地时间及术后髋关节Harris功能评分。结果:P组患者术中出血量少于H组,手术操作时间短于H组,而术后下地时间较H组晚,差异均有统计学意义(P<0.05);术后P组Harris功能评分及优良率均高于H组,差异有统计学意义(P<0.05)。结论:PFNA手术简便,手术耗时短,术中出血少,且术后髋关节功能水平恢复显著,是治疗老年骨质疏松性IFF的较为理想手术方法。

Objective： To observe the efficacy of proximal femoral nail fixation（PFNA） and artificial hip replacement（HA） on osteoporotic intertrochanteric fracture（IFF）.Method： The 67cases with osteoporotie IFF were selected, they were divided into P group（33 cases, treat for PNFA） and H group（34 cases, treat for HA） according to the operation mode, the average operation time, intraoperative blood loss, postoperative load time and the Harris function score of the hip joint after operation were recorded and compared between two groups.Result： The amount of bleeding in group P was less than group H, the operation time in group P was shorter than group H（P〈0.05）.The group H had earlier postoperative load time（P〈0.0S）.The Harris score and excellent rate in group P were significantly higher than group H（P〈0.05）.Conelusion： PFNA is an ideal surgical method for the treatment of senile osteoporotic IFF.It has the advantages of simple operation, short operation time and less bleeding during operation, and the functional level of the hip joint has been restored remarkably.