PFNA与LCP在老年不稳定股骨粗隆间骨折治疗中的疗效观察

Effect observation of PFNA and LCP in the treatment of elder patients with instability femoral intertrochanteric fracture

目的探讨防旋股骨近端髓内钉(PFNA)及锁定加压钢板(LCP)内固定在老年不稳定股骨粗隆间骨折治疗中的临床疗效。方法以我院2013年5月至2017年5月收治的170例老年不稳定股骨粗隆间骨折患者为研究对象,采用双盲法将患者分为对照组和研究组,每组85例。对照组患者在术中行LCP内固定,研究组患者在术中行PFNA内固定。对比两组患者的手术情况、髋关节功能及术后并发症发生情况。结果研究组患者的手术时间、术中出血量、切口长度、住院时间及骨折愈合时间均显著优于对照组(P<0.05);研究组髋关节功能优良率及并发症总发生率分别为95.29%、2.35%,优于对照组的75.29%、15.29%(P<0.05)。结论与LCP比较,PFNA在改善患者的髋关节功能、减少并发症、提高手术效果方面效果更为显著,在老年不稳定股骨粗隆间骨折治疗中具有重要的临床应用意义。

Objective To investigate the clinical effects of proximal femoral nail antirotation(PFNA)and locking compression plate(LCP)in the treatment of unstable femoral intertrochanteric fractures in the elderly.Methods A total of170cases of elder patients with unstable femoral intertrochanteric fractures admitted in our hospital from May2013to May2017were enrolled in this study,and divided into control group and research group according to double-blind method,with85cases in each group.Patients in the control group were given LCP internal fixation,while patients in the research group were given PFNA internal fixation.The surgery situation,hip joint function and occurrence of complications after operation were compared.Results The operation time,intraoperative blood loss,incision length,hospital stay and fracture healing time in the research group were significantly better than those in the control group(P<0.05).The excellent and good rate of hip function and the total incidence of complications in the research group were95.29%and2.35%respectively,which were significantly superior to75.29%and15.29%of the control group(P<0.05).Conclusion Compared with LCP,PFNA has more advantages in improving the hip functions of patients,reducing the complications and raising the operative results,which has important clinical significance in elder patients with instability intertrochanteric fracture.