半髋关节置换术与PFNA内固定术治疗不稳定型股骨粗隆间骨折的疗效对比

Efficacy comparison of hemiarthroplasty and PFNA internal fixation in the treatment of unstable intertrochanteric fracture of femur

目的分析半髋关节置换术与防旋股骨近端髓内钉(PFNA)内固定术治疗不稳定型股骨粗隆间骨折的临床疗效。方法68例不稳定型股骨粗隆间骨折患者,采用随机数字表法分为观察组和对照组,各34例。对照组采用PFNA内固定术治疗,观察组采用半髋关节置换术治疗。比较两组手术情况(手术时间、术中出血量、术后引流量、患侧肢体负重时间)及并发症发生情况。结果观察组手术时间(85.62±4.29)min长于对照组(57.35±4.23)min,患侧肢体负重时间(14.36±1.83)d短于对照组(25.19±3.31)d,术中出血量(239.49±17.82)ml及术后引流量(85.91±12.44)ml均明显多于对照组(110.39±12.05)、(69.43±10.52)ml,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论半髋关节置换术与PFNA内固定术治疗不稳定型股骨粗隆间骨折各有优缺点,医生临床应用可依据需要进行客观选择。

Objective To analyze the clinical efficacy of hemiarthroplasty and proximal femoral nail anti-rotation(PFNA)internal fixation in the treatment of unstable intertrochanteric fracture of femur.Methods A total of 68 patients with unstable intertrochanteric fracture of femur were divided into observation group and control group according to the random numerical table,with 34 cases in each group.The control group was treated with PFNA internal fixation,and the observation group was treated with hemiarthroplasty.The surgical status(operative time,intraoperative blood loss,postoperative drainage,weight-bearing time of the affected limb),and the occurrence of complications were compared between the two groups.Results The operative time of(85.62±4.29)min in the observation group was longer than that of(57.35±4.23)min in the control group;the weight-bearing time of the affected limb of(14.36±1.83)d in the observation group was shorter than that of(25.19±3.31)d in the control group;the intraoperative blood loss of(239.49±17.82)ml and postoperative drainage of(85.91±12.44)ml in the observation group were significantly more than those of(110.39±12.05)and(69.43±10.52)ml in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Hemiarthroplasty and PFNA internal fixation have their own advantages and disadvantages in the treatment of unstable intertrochanteric fracture of femur,and doctors can make an objective choice according to their needs.