PFNA与PFN内固定治疗老年股骨粗隆间骨折的临床疗效

Clinic Effect of PFNA and PFN Internal Fixation on Femoral Intertrochanteric Fractures in the Elderly

目的比较股骨近端髓内钉(PFN)与股骨近端带锁髓内钉(PFNA)内固定治疗老年股骨粗隆间骨折的临床效果。方法回顾性分析2016年2月至2018年10月在太湖县人民医院就诊的55例股骨粗隆间骨折的老年患者资料,依据治疗方法不同将患者分为PFNA组(35例)与PFN组(20例),所有患者均行全身麻醉或连续硬膜外麻醉,取相同的手术位,PFN组采用PFN内固定,PFNA组采用PFNA固定。比较两组患者的手术时间、术中出血量、住院时间、骨折愈合时间和术后完全负重时间,并记录两组患者的不良反应发生情况。结果PFNA组患者的手术时间、住院时间、骨折愈合时间和术后完全负重时间均明显短于PFN组,术中出血量更少,组间比较,差异均有统计学意义(P<0.05)。PFNA组患者的不良反应发生率明显低于PFN组,差异有统计学意义(P<0.05)。结论PFNA手术简单实用,可在更短的手术时间内获得牢固的固定,手术创伤小,术中出血量少,骨折愈合和术后完全负重时间短,是治疗老年股骨粗隆间骨折的良好方法,且安全性高。

Objective To compare the therapeutic effect of PFNA and PFN internal fixation on femoral intertrochanteric fractures(FIF)in the elderly.Methods A retrospective analysis of clinical data was conducted in 55 elderly patients with FIF who were admitted to Taihu County People’s Hospital from February 2016 to October 2018.Patients were divided into a PFNA group(35 cases)and a PFN group(20 cases)according to different treatment methods.All patients underwent general anesthesia or continuous epidural anesthesia,and took the same operative position.PFN internal fixation was used in the PFN group,PFNA group was fixed with PFNA.The surgery time,intraoperative blood loss,the length of hospital stay,fracture healing time,and postoperative full weight bearing time were compared.The adverse reactions of the two groups were recorded.Results Patients in the PFNA group had significantly shorter surgery time,hospital stay,fracture healing time,and postoperative full weight bearing time,as well as less intraoperative blood loss,compared with those in the PFN group(P<0.05).The incidence of adverse reactions in the PFNA group was significantly lower than the PFN group(P<0.05).Conclusion PFNA is a simple and practical operation,through which a solid fixation can be achieved in shorter operative time.It was effective on treating the elderly with FIF with little operative trauma,low intraoperative blood loss,short fracture healing time and postoperative full weight bearing time,and high safety.