标准股骨近端防旋髓内钉和加长股骨近端防旋髓内钉在骨质疏松性粗隆间骨折中的疗效比较

Comparison of the Clinic Effects Between Standard and Lengthened PFNA in Treating Osteoporosis Interchanteric Fracture

目的比较标准股骨近端防旋髓内钉(PFNA)和加长PFNA在骨质疏松性粗隆间骨折中的疗效。方法回顾性分析了2012年1月—2015年6月收治的粗隆间骨折患者的资料,根据手术中采用的固定材料分为常规组和加长组,分析比较两组患者性别、年龄、受伤机制、骨折分型、住院时间;还分析了术中信息,包括失血量、手术时间、是否输血等,以及术后切口愈合情况、内固定周围骨折、大腿外侧疼痛等手术并发症。结果两组患者年龄、性别、骨折分型、受伤机制及术前血红蛋白水平等均无显著性差异。加长组较常规组术中失血量显著增加;加长组较常规组手术时间显著延长;加长组较常规组输血率显著增加;加长组较常规组术后大腿外侧疼痛显著减少。两组住院时间、内固定周围骨折、畸形愈合发生无显著性差异,两组均无切口感染、骨折不愈合及内固定失败发生。结论加长PFNA能够降低大腿外侧疼痛的发生,但却延长了手术时间和增加了术中失血量。

Objective To compare the clinic effect of standard PFNA and lengthened PFNA in treating osteoporotic intertrochanteric fracture. Method The clinical features of the patients suffered from osteoporotic intertrochanteric fracture were retrospectively analyzed. The patients were divided into routine group and lengthened group according to the use of standard or lengthened PFNA.The data of gender,age,traumatic mechanism,classification,the length of hospital stay,blood loss,operation time,the rate of transfusion,wound healing,periprosthetic fractures,thigh pain,malunion and the time of bone union were compared. Results There is of no significant difference between the two groups in the age,gender,classification,traumatic mechanism and perioperative hemoglobin. Compared with the routine group,the blood loss increases,operation time is prolonged,and the rate of thigh pain decreases in the lengthened group. There is no infection,nonunion and internal fixation failure in both groups. Conclusion Lengthened PFNA decreases the thigh pain,but prolongs the operation time and blood loss.