防旋转股骨近端髓内钉与interTan髓内钉治疗股骨转子间骨折的效果对比

Comparison of the Effect of Antirotatory Proximal Femoral Intramedullary Nail and InterTan Intramedullary Nail in the Treatment of Intertrochanteric Fracture

目的探讨防旋转股骨近端髓内钉(PFNA)与InterTan髓内钉治疗股骨转子间骨折的效果。方法回顾分析本院2020年1月-2022年9月收治对的86例股骨转子间骨折患者临床资料,根据不同手术方式分为PF组和Tan组,各43例。PF组行防旋转股骨近端髓内钉内固定术治疗,Tan组采用InterTan髓内钉内固定术治疗,比较两组手术效果和患者髋关节功能恢复情况。结果Tan组手术时间长于PF组,出血量多于PF组,组间差异(P<0.05),两组下床活动时间、骨折愈合平均时间和住院时间无差异(P>0.05);两组总并发症发生率比较,无差异(P>0.05);两组髋关节功能恢复优良率比较无差异(P>0.05)。结论PFNA术和InterTan髓内钉治疗股骨转子间骨折均有良好效果,但InterTan髓内钉手术操作复杂,时间较长,相较于PFNA,其出血量更多,但其固定强度和防旋转效果略高于PFNA内固定术,临床可根据实际情况酌情选择术式,部分手术耐受性差者可优先选择PFNA内固定术治疗。

Objective To investigate the effect of PFNA and InterTan intramedullary nail in the treatment of intertrochanteric fracture of femur.Methods The clinical data of 86 patients with intertrochanteric fracture admitted to our hospital from January 2020 to September 2022 were retrospectively analyzed and divided into PF group and Tan group according to different surgical methods,with 43 cases in each group.The PF group was treated with intramedullary nailing and intramedullary nailing,while the Tan group was treated with InterTan intramedullary nailing and intramedullary nailing.The operative effect and the recovery of hip joint function were compared between the two groups.Results The operation time in Tan group was longer than that in PF group,and the amount of bleeding was more than that in PF group,and there were no differences between the two groups(P<0.05).There were no differences in the time of getting out of bed,the mean time of fracture healing and the length of hospital stay between the two groups(P>0.05).There was no difference in the total complication rate between the two groups(P>0.05).There was no difference in the recovery rate of hip function between the two groups(P>0.05).Conclusion PFNA and InterTan intramedullary nail both have good results in the treatment of intertrochanteric fractures.However,the operation of InterTan intramedullary nail is complicated and takes longer time.Compared with PFNA,Intertan intramedullary nail has more blood loss,but its fixation strength and anti-rotation effect are slightly higher than that of PFNA.Some patients with poor tolerance can be preferentially treated with PFNA internal fixation.