股骨近端防旋锁定钉与锁定钢板内固定治疗老年股骨粗隆间骨折的疗效比较

Proximal femoral nail antirotation versus internal fixation with locking plate in the treatment of elderly patients with femoral intertrochanteric fracture

目的比较股骨近端防旋锁定钉(PFNA)与锁定钢板内固定治疗老年股骨粗隆间骨折的疗效。方法将90例老年股骨粗隆间骨折患者随机分为2组,PFNA组患者给予PFNA治疗,锁定钢板组患者则给予锁定钢板内固定术,比较2组患者围术期指标、并发症、Harris评分与远期预后。结果 PFNA组患者手术时间、切口长度、术中失血量、术后引流量、下地时间与骨折愈合时间均显著优于锁定钢板组(P <0. 05或P <0. 01)。PFNA组末期随访时Harris总分、生理功能、躯体疼痛与总体健康评分显著高于锁定钢板组(P <0. 01)。PFNA组总并发症发生率显著低于锁定钢板组(P <0. 05)。结论相比于锁定钢板内固定术,PFNA具有创伤低、恢复快、并发症少等优势。

Objective To compare the efficacy of proximal femoral nail antirotation(PFNA)and internal fixation with locking plate in the treatment of elderly patients with femoral intertrochanteric fracture.Methods Totally 90 elderly patients with femoral intertrochanteric fracture were randomly divided into two groups.Patients in the PFNA group received PFNA,and patients in locking plate group were treated with internal fixation of locking plate.Perioperative indicators,complications,the Harris score and long-term prognosis were compared between the two groups.Results The operation time,length of incision,intra-operative blood loss,postoperative drainage volume,time to walking and fracture healing time in the PFNA group were significantly better than those in the locking plate group(P<0.05 or P<0.01).The total score of Harris,physical function,physical pain and overall health score at final follow up in the PFNA group were significantly higher than those in locking plate group(P<0.01).The total incidence rate of complications in the PFNA group was significantly lower than that in the locking plate group(P<0.05).Conclusion PFNA has less trauma,faster recovery speed and fewer complications when compared with internal fixation with locking plate.