两种术式治疗老年股骨粗隆间骨折比较

Proximal femoral nail anti-rotation versus hemiarthroplasty for femoral intertrochanteric fracture in the elderly

[目的]比较股骨近端髓内钉(proximal femoral nail anti-rotation,PFNA)与人工股骨头置换术(hemiarthroplasty,HA)治疗高龄粗隆间骨折的临床疗效.[方法]回顾性分析本院治疗的60例高龄股骨粗隆间骨折患者的临床资料,根据医患沟通结果将患者分为PFNA组23例与HA组37例.比较两组手术相关指标及术后髋关节功能Harris评分.[结果]PFNA组手术时间和术中出血量显著少于HA组(P<0.05),然而,HA组术中透视时间、术后下地负重时间和术后住院时间均显著优于PFNA组(P<0.05).两组术后并发症和术后3、6、12个月髋关节功能Harris评分差异均无统计学意义(P>0.05).[结论]PF-NA和HA治疗高龄股骨粗隆间骨折均具有良好的临床疗效,且各具优点,临床上可根据患者实际情况进行选择.

[Objective]To compare the clinical efficacy of proximal femoral nail anti-rotation(PFNA)versus hemiarthroplasty(HA)for treatment femoral intertrochanteric fractures in the elderly.[Methods]A retrospective study was conducted on 60 elderly patients who underwent surgical treatment for femoral intertrochanteric fracture in our hospital.According to doctor-patient communication results,they were divided into PFNA group(n=23)and HA group(n=37).The operative indicators and Harris score of hip function were compared between the two groups.[Results] The PFNA group proved significantly superior to the HA group in terms of operative time and intraoperative blood loss(P<0.05).Conversely,The PFNA group was significantly inferior to the HA group in terms of intraoperative fluoroscopy times,time to resume walking and hospital stay(P<0.05).There were no statistical significances between two groups in terms of postoperative complications and Harris scores at 3,6 and 12 months after operation(P>0.05).[Conclusion]Both PFNA and HA have good clinical efficacy in the treatment of femoral intertrochanteric fractures in the elderly with own advantages,which should be selected according to the actual situation of each patient.