InterTAN钉与PFNA治疗外侧壁不稳定型股骨转子间骨折的疗效分析

Therapeutic Effect of Intre TAN and PFNA Intramedullary Fixations for the Treatment of Unstable Intertrochanteric Fractures of the Lateral Wall

目的:对比Inter TAN髓内钉及PFNA在治疗外侧壁不稳定型股骨转子间骨折的临床疗效。方法:选取湖北六七二中西医结合骨科医院创伤骨科2014年10月-2018年11月手术治疗的外侧壁不稳定型股骨转子间骨折患者42例,其中Inter TAN髓内钉固定15例,PFNA固定27例,观察两者在术中出血量、手术操作时间、术后下地时间、骨折愈合时间、术后相关并发症及末次随访髋关节功能评分(Harris)。结果:Inter TAN组获访15人,PFNA组获访27人,随访时间6~19个月,平均随访(14.3±1.5)个月,手术相关指标对比PFNA组在术中出血量及手术操作时间方面占有优势(P<0.05);Inter TAN组平均术后下地时间更短(P<0.05);骨折愈合时间两组差异无统计学意义(P>0.05);Inter TAN组出现并发症率为6.67%,PFNA组为14.81%,两者术后并发症率差异有统计学意义(P<0.05);髋关节功能Harris评分:Inter TAN组优良率为93.3%,PFNA组为85.2%,差异有统计学意义(P<0.05)。结论:Inter TAN作为一种较新型内固定,加压效果明显,抗旋转作用强,能够提供更好的稳定性,术后下地早、并发症少,治疗外侧壁破裂的股骨转子间骨折疗效显著,为临床骨科医师提供了更好的选择。

Objective:To compare the clinical efficacy of InterTAN intramedullary nail and PFNA in the treatment of unstable intertrochanteric fractures of the lateral wall.Methods:A total of 42 patients with unstable lateral femoral intertrochanteric fractures who underwent surgery from October 2014 to November 2018 in Hubei 672 Orthopedic Hospital of Integrated Chinese and Western Medicine were selected.Among them,InterTAN intramedullary nailing was performed in 15 cases,PFNA was used in 27 cases.The intraoperative blood loss,operation time,postoperative ground time,fracture healing time,postoperative complications and hip function score(Harris)were observed.Results:15 patients were interviewed in the InterTAN group and 27 in the PFNA group.The follow-up period was 6~19 months,and the average follow-up time was(14.3±1.5)months.The intraoperative blood loss and operation time of the PFNA group compared with the InterTAN group had an advantage(P<0.05);InterTAN group had shorter postoperative ground time(P<0.05);fracture healing no significant difference between the two groups(P>0.05);The complication rate was 6.67%in the InterTAN group and 14.81%in the PFNA group.The postoperative complication rate was statistically significant(P<0.05).Hip function Harris score:InterTAN group excellent rate was 93.3%,PFNA group was 85.2%(P<0.05),which was statistically significant.Conclusion:InterTAN as a new type of internal fixation,obvious pressure effect,strong anti-rotation effect,can provide better stability,early postoperative early,less complications,treatment of external rupture of the intertrochanteric fractures of the femur is significant,for clinical Orthopaedic surgeons offer a better choice.