PFLCP与PFNA治疗老年股骨转子间骨折伴骨折侧中重度膝骨性关节炎患者的效果比较

Comparison of the Efficacy of PFLCP and PFNA in the Treatment of Elderly Patients with Intertrochanteric Fracture of the Femur Accompanied by Moderate to Severe Knee Osteoarthritis on the Fracture Side

目的比较股骨近端锁定加压钢板(proximal femur locking compression plate,PFLCP)与股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗老年股骨转子间骨折伴骨折侧中重度膝骨性关节炎(knee osteoarthritis,KOA)的临床效果。方法选取2014年6月—2018年8月我院收治的45例老年股骨转子间骨折伴骨折侧中重度KOA患者,按照手术内固定方式的不同分为两组,21例采用PFLCP固定(PFLCP组),24例采用PFNA固定(PFNA组)。记录并比较2组住院时间、手术时间、术中出血量、术后下地时间、围术期并发症发生情况、骨折愈合时间及术后1年髋关节功能Harris评分。结果PFNA组手术时间、术后下地时间短于PFLCP组,术中出血量明显少于PFLCP组,差异有统计学意义(P<0.05或P<0.01)。2组住院时间、骨折愈合时间、围术期并发症发生率及术后1年髋关节功能Harris总评分比较差异均无统计学意义(P>0.05)。结论PFLCP和PFNA均是治疗老年股骨转子间骨折伴骨折侧中重度KOA患者的有效方式,但后者手术时间短,术中出血少,术后下地时间早。

Objective To compare the efficacy of proximal femur locking compression plate(PFLCP)and proximal femoral nail antirotation(PFNA)in the treatment of elderly patients with intertrochanteric fracture of the femur accompanied by moderate to severe knee osteoarthritis(KOA)on the fracture side.Methods A total of 45 elderly patients with intertrochanteric fracture of the femur accompanied by moderate to severe KOA on the fracture side admitted to our hospital from June 2014 to August 2018 were selected and divided into two groups according to different internal fixation methods.Twenty-one patients were treated with PFLCP fixation and 24 with PFNA fixation.Length of hospitalization,duration of operation,intraoperative blood loss,time to get off bed after operation,perioperative complications,fracture healing time and Harris hip score at 1 year after surgery were recorded and compared between the 2 groups.Results Theduration of operation and time to get off bed after operation of PFNA group were shorter than those of PFLCP group,and the intraoperative blood loss was significantly less than that of PELCP group(P<0.05 or P<0.01).There were no statistically significant differences in duration of hospital stay,fracture healing time,incidence of perioperative complications,and total Harris hip score at 1 year after surgery between the 2 groups(P>0.05).Conclusion Both PFLCP and PFNA are effective methods to treat elderly patients with intertrochanteric fracture of the femur accompanied by moderate to severe KOA on the fracture side,but the latter has shorter duration of operation,less intraoperative bleeding and earlier time to get off bed after operation.