股骨近端防旋髓内钉与InterTAN髓内钉治疗老年不稳定股骨粗隆间骨折的疗效比较

Comparison of PFNA and InterTAN intramedullary nail in the treatment of unstable intertrochanteric fracture of femur in elderly patients

目的分析比较股骨近端防旋髓内钉(PFNA)和InterTAN髓内钉对老年不稳定型股骨粗隆间骨折的临床疗效。方法选取2017年7月至2018年11月本院符合诊断及纳入标准的股骨粗隆间骨折患者60例,根据手术方法随机分为观察组和对照组,各30例。其中观察组采取PFNA,对照组采用InterTAN髓内钉治疗。分析比较两组患者术中、术后及并发症发生情况。结果与对照组比较,观察组手术时间、术中出血量和术中透视时间均明显减少,差异有统计学意义(P<0.01);观察组患者术后早期负重时间、骨折愈合时间、随访时Harris评分、术后并发症发生率与对照组比较,差异无统计学意义。结论PFNA与InterTAN在IFF的治疗上均取得满意的远期疗效,但对于骨质疏松和手术耐受力差的老年IFF患者手术应优先选择PFNA。

Objective To compare the clinical efficacy of proximal femoral anti-rotation intramedullary nail(PFNA)and InterTAN intramedullary nail in elderly patients with unstable intertrochanteric fracture of femur.Methods From July 2017 to November 2018,60 patients with intertrochanteric fracture of femur who met the diagnostic and inclusion criteria in our hospital were selected,and were randomly divided into observation group and control group,with 30 cases in each group.The observation group was treated with PFNA,while the control group was treated with Inter-TAN intramedullary nail.The operative,postoperative and complications of the two groups were analyzed and compared.Results Compared with the control group,the operation time,intraoperative bleeding volume and intraoperative fluoroscopy time of the observation group were significantly reduced(P<0.01).There were no significant differences in early weight-bearing time,fracture healing time,Harris score at the last follow-up,incidence of postoperative complications between the observation group and the control group.Conclusion Both PFNA and InterTAN have satisfactory long-term efficacy inelderly patients with unstable intertrochanteric fracture of femur,but PFNA is preferred for elderly patients with osteoporosis and poor surgical tolerance.