双动半髋关节置换术与PFNA内固定术治疗老年股骨转子间骨折的中期疗效及安全性比较

Mid-term efficacy and safety of double-action hemiarthroplasty and PFNA internal fixation in the treatment of elderly paitents with intertrochanteric fractures

目的比较股骨近端髓内钉(PFNA)内固定术及双动半髋关节置换术治疗老年股骨转子间骨折患者的中期疗效及安全性。方法选取2016年1月至2018年1月到忻州市人民医院进行治疗且符合入组标准的老年股骨转子间骨折患者共180例,根据治疗方式将其分为PFNA组146例与半髋置换组34例,对比两组患者的治疗效果。结果半髋置换组患者的负重时间、骨愈合时间更短;PFNA组患者的出血量更少,手术时间、住院时间更短(P<0.05)。术后6个月,半髋置换组患者的Harris评分高于PFNA组(P<0.05);术后12个月,两组患者的Harris评分比较差异未见统计学意义(P>0.05)。随访期间两组患者并发症发生情况比较差异未见统计学意义(P>0.05)。结论PFNA内固定术及双动半髋关节置换术各具优势,后者短期疗效更佳,但两者中期疗效相近,且均具有良好的安全性。

Objective To compare the mid-term efficacy and safety of proximal femoral nail (PFNA) internal fixation and double-action hemiarthroplasty in the treatment of elderly patients with intertrochanteric fracture. Methods A total of 180 elderly patients with intertrochanteric fractures who met the criteria of enrollment in People’s Hospital of Xinzhou from January 2016 to January 2018 were enrolled. They were divided into PFNA group (146 cases) and hemiarthroplasty group (34 cases) by treatment methods. The therapeutic effects were compared between the two groups. Results The weight-bearing time and bone healing time were shorter in hemiarthroplasty group. The PFNA group had less bleeding, shorter operation time and hospital stay (P<0.05). Six months after surgery, the Harris score of hemiarthroplasty group was significantly higher than that of PFNA group (P<0.05), but there was no significant difference in Harris score between the two groups 12 months after surgery (P>0.05). There was no significant difference in the incidence of complications between the two groups during the follow-up period (P>0.05). Conclusions PFNA internal fixation and hemiarthroplasty replacement have their own advantages. The latter has better short-term curative effects, but theirmid-term curative effects are similar, and both of which have good safety.