PFNA与倒置LISS钢板治疗A2型股骨粗隆间骨折临床疗效对比分析

发布时间：2018-03-05 15:53

本文选题：PFNA　切入点：LISS钢板　出处：《宁夏医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨PFNA与倒置LISS钢板治疗A2型股骨粗隆间骨折临床疗效,对A2型股骨粗隆间骨折的治疗及预后评价提供更好的临床依据。方法回顾性分析自2012年8月至2016年2月间就诊于宁夏医科大学总医院创伤骨科并接受PFNA与倒置LISS钢板治疗的A2型股骨粗隆间骨折40例患者的临床资料,其中3例失访,37例患者获得全程随访。男19例,女18例,年龄48-69岁,平均年龄(58.6±10.4)岁。其中18例采用PFNA内固定,19例行倒置LISS内固定,收集两组手术时间(从手术开始到手术结束,包括术中透视时间)、术中出血量、术后切口引流量、手术切口长度、住院时间、术后负重时间、骨折愈合时间、术后并发症(髋内翻程度、内固定失败率、肺部感染、深静脉血栓形成及股骨头坏死)、术后Harris评分的数据,通过统计学分析对其疗效进行比较。结果37例获全程随访患者,随访时间为12~18个月,平均约14个月。PFNA组与倒置LISS钢板组手术时间分别为(62.4±10.3)、(103.5±16.7)min,术中出血量分别为(175.4±31.6)、(283.7±27.4)ml,术后切口引流量分别为(69.3±6.5)、(125.4±5.8)ml,手术切口长度分别为(6.2±1.3)、(7.2±1.9)cm,住院时间分别为(7.1±1.2)、(7.3±1.1)天,术后负重时间分别为(17.8±1.6)、(38.0±2.4)天,骨折愈合时间分别为(12.2±1.9)、(11.1±2.3)周。两组手术时间、术中出血量、切口长度、术后负重时间、引流量、并发症及髋关节功能恢复方面比较有显著性差异(P0.05),在住院时间及骨折愈合时间方面比较无显著性差异(P0.05)。结论PFNA与倒置LISS钢板治疗A2型股骨粗隆间骨折都可以得到让人满意的疗效。在A2型股骨粗隆间骨折的治疗方面PFNA内固定要优于倒置LISS钢板固定,具有手术时间短、创伤小、出血量少、卧床时间短、并发症少等优点,有显著的临床疗效,值得推广。
[Abstract]:Objective to investigate the clinical effect of PFNA and inverted LISS plate in the treatment of type A2 intertrochanteric fracture of femur. To provide better clinical basis for the treatment and prognosis evaluation of type A2 intertrochanteric fracture. Methods from August 2012 to February 2016, a retrospective analysis was conducted in the Department of Trauma and Orthopaedics, Ningxia Medical University General Hospital, and received PFNA and inverted LISS. Clinical data of 40 patients with A2 type intertrochanteric fracture treated with steel plate. Three of them were followed up for the whole course. There were 19 males and 18 females, aged 48 to 69 years, with an average age of 58.6 卤10.4 years. Among them, 18 cases were treated with PFNA internal fixation and 19 cases were treated with inverted LISS internal fixation, and the operation time was collected from the beginning of operation to the end of operation. It includes time of fluoroscopy, amount of blood lost during operation, drainage of incision after operation, length of incision, length of hospital stay, time of weight bearing after operation, time of fracture healing, postoperative complications (degree of hip varus, failure rate of internal fixation, pulmonary infection). The data of Harris score after operation were compared by statistical analysis. Results 37 patients were followed up for 12 ~ 18 months. The mean operation time was 62.4 卤10.3 卤16.7 min, the intraoperative bleeding volume was 175.4 卤31.6 卤27.4 ml, the incision drainage volume was 69.3 卤6.5 卤5.8ml, the incision length was 6.2 卤1.3U / h 7.2 卤1.9cm, the hospitalization time was 7.1 卤1.21g / kg 卤1.1) days, and the postoperative weight loading time was 17.8 卤1.6 卤2.4m / min, respectively, and the operative incision length was 6.2 卤1.3U / min 卤1.9cm, respectively, and the length of the incision was 6.2 卤1.3U / L 卤1.9mm. the hospital stay was 7.1 卤1.21.2U / min, respectively, and the postoperative weight loading time was 17.8 卤1.6 / kg / kg / kg, 38.0 卤2.4m / d, respectively, and the operative incision length was 6.2 卤1.3U / min (7.2 卤1.9cm), and the hospital stay was 7.1 卤1.2U / min 卤1.1g / min. The healing time of fracture was 12.2 卤1.9 and 11.1 卤2.3 weeks respectively. There were significant differences in complications and hip function recovery (P 0.05), but there was no significant difference in hospital stay and fracture healing time. Conclusion both PFNA and inverted LISS plate can be used to treat A2 type intertrochanteric fracture of femur. PFNA internal fixation is superior to inverted LISS plate fixation in the treatment of type A2 intertrochanteric femoral fractures. It has the advantages of short operation time, less trauma, less bleeding, shorter bed-rest time and less complications. It has remarkable clinical effect and is worth popularizing.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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