股骨近端防旋髓内钉治疗老年股骨转子间骨折的疗效

Efficacy of proximal femoral nail anti-rotation in the treatment of elderly intertrochanteric fracture

目的探讨股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的临床疗效。方法将90例老年股骨转子间骨折患者按随机数字表法分为PFNA组及动力髋螺钉(DHS)组,各45例。比较两组切口长度、手术时间、术中出血量、骨折愈合时间、并发症发生率及末次随访时髋关节功能Harris评分。结果患者均获得随访,时间12~18个月。切口长度、手术时间、术中出血量、骨折愈合时间PFNA组均短(少)于DHS组(P<0.05)。并发症发生率PFNA组低于DHS组(P<0.05)。末次随访时髋关节功能Harris评分PFNA组高于DHS组(P<0.05)。结论相较于DHS,PFNA治疗老年股骨转子间骨折具有微创、手术时间短、术中出血量少、骨折愈合快、术后并发症少、患者功能恢复好等优点。

Objective To investigate the clinical efficacy of proximal femoral nail anti-rotation(PFNA)in the treatment of elderly femoral intertrochanteric fracture.Methods The 90 elderly patients with intertrochanteric fractures were divided into PFNA group and dynamic hip screw(DHS)group,with 45 cases in each group.The following data were compared between two groups,including the incision length,surgical time,intraoperative bleeding volume,fracture healing time,the incidence rate of complications,and Harris scores of hip function at the last follow-up.Results All patients were followed up for 12~18 months.The incision length,surgical time,intraoperative bleeding volume and fracture healing time in the PFNA group were shorter(less)than those in DHS group(P<0.05);the incidence rate of complications was lower in the PFNA group than DHS group(P<0.05).At the last follow-up,the Harris scores of hip function in the PFNA group was higher than that of the DHS group(P<0.05).Conclusions Compared with DHS,PFNA is used to treat the femoral intertrochanteric fractures,which has the advantages of minimally invasive,shorter operation time,less intraoperative bleeding,faster fracture healing,fewer complications,and faster functional recovery of patients.