普通型与加长型股骨近端防旋髓内钉治疗股骨转子间骨折的比较

Comparision of short and long proximal femoral nail antirotation for treatment of intertrochanteric femur fractures

目的 :探讨普通型与加长型股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗股骨转子间骨折的临床效果。方法:回顾性分析我院自2008年1月—2013年5月使用PFNA治疗股骨转子间骨折的患者215例中获得随访157例的临床资料,行普通型PFNA固定92例(普通组),行加长型PFNA固定65例(加长组)。比较两组患者的手术时间、失血量、术后住院时间、骨折愈合时间、内固定周围骨折发生率等。结果:两组手术时间、失血量t检验显示差异有统计学意义(P=0.001、0.002);术后住院时间、骨折愈合时间比较差异无统计学意义(P=0.365、0.249)。结论:老年患者的股骨近端骨折使用髓内钉可取得良好的治疗效果;选择不同长度的PFNA需根据患者的骨折类型、医师的操作习惯等综合考虑。

Objective: To in vestigate the comparison of curative effects in treating intertrochanteric femur fracture patients between long and short proximal femoral nail antirotation. Methods: In the study, 215 patients of intertrochanteric femur fracture from January 2008 to May 2013 in our hospital were analyzed retrospectively, of whom 157 were followed up. There were92 cases treated with short intramedullary nails and 65 cases. The patients were followed up with operation time, blood loss,postoperative hospital day, fracture union time and incidence of periprosthetic fracture. Results: According to the t test: there were significant differences in operation time(P=0.001) and blood loss(P=0.002) between short intramedullary nails group and long intramedullary nails group. There were no significant differences in postoperative hospital day(P=0.365) and clinical union time of bone(P=0.249) between short intramedullary nails group and long intramedullary nails group. Conclusion: Elderly intertrochanteric femur fracture patients treated with proximal femoral nail antirotation can achieve good curative effects, and how to make a choose of different length of proximal femoral nail be based on the type of fractures, operationg habits of doctors and other factors considered.