两种内固定治疗老年股骨转子间骨折的疗效比较

Efficacy comparison of two kinds of internal fixation for femoral intertrochanteric fracture

目的比较股骨近端防旋髓内钉(PFNA)和股骨近端锁定钢板内固定治疗老年股骨转子间骨折的疗效。方法将120例老年股骨转子间骨折患者根据治疗方法不同分为PFNA组(70例)和锁定钢板组(50例)。比较两组手术情况、骨折愈合情况、并发症发生情况、疼痛VAS评分及髋关节功能Harris评分。结果患者均获得随访,锁定钢板组随访时间20~40周,PFNA组随访时间15~25周。手术时间、住院时间、骨痂形成时间、骨折愈合时间、并发症发生率PFNA组均短(低)于锁定钢板组(P<0.05)。末次随访时,疼痛VAS评分及髋关节功能Harris评分PFNA组均优于锁定钢板组(P<0.05)。结论与股骨近端锁定钢板内固定相比,PFNA固定治疗老年股骨转子间骨折具有手术时间短、并发症少、患者术后康复快以及髋关节功能恢复好的优点。

Objective To compare the efficacy of proximal femoral nail anti-rotation(PFNA)and proximal femoral locking plate for treatment of femoral intertrochanteric femoral fractures in the elderly.Methods A total of 120 elderly patients with femoral intertrochanteric fractures were divided into PFNA group(70 cases)and locking plate group(50 cases),according to different treatment methods.The situations of operation,fracture healing,complications,and pain VAS,Harris score of hip function were compared between the two groups.Results All patients were followed up,and follow-up time was 20~40 weeks in the locking plate group,and 15~25 weeks in the PFNA group.The operation time,hospital stay,callus formation time,fracture healing time and complication incidence rate in PFNA group were shorter(lower)than those in locking plate group(P<0.05).At the last follow-up,pain VAS and Harris score of hip joint function in PFNA group were better than those in locking plate group(P<0.05).Conclusions Compared with proximal femoral locking plate,PFNA has the advantages of less operative time,few complications,fast postoperative recovery and good recovery of hip function in the treatment of femoral intertrochanteric fractures.