股骨近端抗旋髓内钉与股骨近端锁定钢板治疗老年股骨转子间骨折的临床效果

Clinical effects of proximal femoral nail anti-rotation and locking proximal femoral plate in the treatment of femoral intertrochanteric fracturein the elderly

目的比较股骨近端抗旋髓内钉(PFNA)与股骨近端锁定钢板(LPFP)治疗老年股骨转子间骨折的临床效果。方法回顾性分析2015年1月至2019年3月于空军军医大学第二附属医院骨科进行PFNA和LPFP手术治疗的132例老年股骨转子间骨折患者的临床资料,按照内固定方法将其分为PFNA组(81例)和LPFP组(51例)。比较两组患者的骨折分型、围手术期相关指标以及术后髋关节功能。结果两组患者的骨折分型无显著差异(P>0.05)。PFNA组的住院时间、手术时间、负重时间、骨折愈合时间短于LPFP组,切口长度小于LPFP组,术中出血量、引流量少于LPFP组(P<0.05)。术后3、6、12个月,PFNA组的髋关节功能优于LPFP组(P<0.05)。结论PFNA和LPFP在治疗老年人股骨转子间骨折方面均能取得良好的效果,但PNFA创伤更小,患者恢复更快,并发症发生率低,值得推广。

Objective To compare the clinical effects of proximal femoral nail anti-rotation(PFNA)and locking proximal femoral plate(LPFP)in the treatment of femoral intertrochanteric fracture in the elderly.Methods The clinical data of 132 elderly patients with femoral intertrochanteric fracture treated with PFNA and LPFP from January 2015 to March 2019 in the orthopedic department of the second affiliated hospital of air force military medical university were retrospectively analyzed.The patients were divided into PFNA group(81 cases)and LPFP group(51 cases)according to the internal fixation method.Fracture classification,perioperative related indexes and hip joint function after operation were compared between the two groups.Results There was no significant difference in fracture classification between the two groups(P>0.05).The hospital stay,operation time,weight-bearing time and healing time of fracture of the PFNA group were shorter than those of the LPFP group,the incision length was smaller than that of the LPFP group,and the amount of intraoperative blood loss and drainage were less than those of the LPFP group(P<0.05).After 3,6 and 12 months of operation,the hip joint function of the PFNA group were better than those of the LPFP group(P<0.05).Conclusion Both PFNA and LPFP are effective in the treatment of femoral intertrochanteric fracture in the elderly.However,PNFA had less trauma,faster recovery of patients,and lower incidence of complications,which is worthy of promotion.