股骨近端防旋髓内钉与双极人工股骨头置换治疗股骨近端骨折的临床疗效分析

Analysis of the clinical effectiveness of proximal femoral nail anti-rotation and bipolar hemiarthroplasty in the treatment of proximal femoral fractures

目的探讨股骨近端防旋髓内钉与双极人工股骨头置换用于股骨近端骨折的临床疗效。方法回顾分析徐州医科大学附属医院159例股骨近端骨折患者,依手术方式分为股骨近端防旋髓内钉(PFNA)组和双极人工股骨头置换(BH)组,比较2组治疗效果。结果PFNA组手术时间、术中出血量、切口长度及术后引流量均低于BH组,负重时间高于BH组,差异有统计学意义(P<0.05)。2组患者住院时间、术后1年Harris评分及早期并发症发生率之间差异无统计学意义,BH组晚期并发症发生率高于PFNA组。结论股骨近端防旋髓内钉与双极人工股骨头置换治疗股骨近端骨折各具优点,需根据患者情况严格把握手术适应证进行选择。

Objective To compare the clinical effectiveness of proximal femoral nail anti-rotation and bipolar hemiarthroplasty for proximal femoral fracture.Methods Retrospective analysis was performed,where 159 patients with proximal femoral fractures in the Affiliated Hospital of Xuzhou Medical University were selected.According to their surgical methods,they were divided into two groups:a proximal femoral nail anti-rotation(PFNA)group and a bipolar hemiarthroplasty(BH)group.Both groups were compared for their therapeutic effectiveness.Results The PFNA group showed remarkable decreases in the operation time,intraoperative blood loss,length of incision and postoperative drainage volume,as well as increases in weight-bearing time,compared with the BH group(P<0.05).There was no significant difference in the length of hospitalization stay,one-year Harris score and the incidence of early complications between the two groups.But the incidence of late complications in the BH group was significantly higher than that in the PFNA group.Conclusions Both proximal femoral nail anti-rotation and bipolar hemiarthroplasty have their own advantages.It is necessary to strictly follow the surgical indications to select,with respect to patient conditions.