PFNA和人工股骨头置换术治疗高龄患者股骨粗隆间骨折的疗效对比

发布时间：2018-04-28 14:40

本文选题：股骨近端防旋髓内钉 + 人工股骨头置换术　；参考：《生物骨科材料与临床研究》2016年06期

【摘要】：目的比较股骨近端防旋髓内钉(Proximal femoral antirotation nail,PFNA)和人工双极股骨头置换术(Bipolar hemiarthroplasty,BHA)治疗高龄患者股骨粗隆间骨折的疗效和早期功能恢复情况。方法回顾性分析2013年6月~2015年6月间本科室收治的高龄股骨粗隆间骨折患者,其中行PFNA治疗41例,行BHA治疗32例。获取患者的一般情况、骨折类型、ASA评分、手术方式、术中出血量、术中透视次数、患肢完全负重时间以及HHS评分等指标。结果 PFNA组有2位患者失访,BHA组有1位患者失访,其余患者均获半年以上随访。术前两组患者的一般特征,包括性别构成比、骨折分型、ASA评分等,组间比较,差异无统计学意义(P0.05)。手术时间、围手术期失血量等指标,组间比较,差异无统计学意义(P0.05),但术中失血量BHA组稍高于PFNA组,差异有统计学意义(P0.05)。术中透视次数BHA组明显少于PFNA组,差异有统计学意义(P0.05)。患肢完全负重时间,BHA组明显短于PFNA组,差异有统计学意义(P0.05)。术后1周HHS评分,BHA组明显高于PFNA组,差异有统计学意义(P0.05)。术后半年HHS评分,组间比较差异无显著意义(P0.05)。结论PFNA和BHA均是治疗高龄粗隆间骨折患者的有效手段。与PFNA相比,BHA具有手术透视次数少、术后功能恢复快等优势。
[Abstract]:Objective to compare the efficacy and early functional recovery of Proximal femoral antirotation nailna (PFNA) and Bipolar hemithroplasty (Bipolar hemithroplasty) in the treatment of femoral intertrochanteric fractures in elderly patients. Methods from June 2013 to June 2015, 41 elderly patients with intertrochanteric fracture of femur were treated with PFNA and 32 with BHA. To obtain the general situation of the patients, fracture type of ASA score, surgical methods, intraoperative blood loss, intraoperative fluoroscopy times, full weight bearing time of the affected limb, and HHS score, and so on. Results there were 2 patients in PFNA group and 1 patient in BHA group. The other patients were followed up for more than half a year. There was no significant difference between the two groups in general characteristics, including sex ratio, fracture classification and ASA score, and there was no significant difference between the two groups (P 0.05). There was no significant difference in operation time and perioperative blood loss between the two groups, but the blood loss in BHA group was slightly higher than that in PFNA group, and the difference was statistically significant (P 0.05). The number of fluoroscopy in BHA group was significantly lower than that in PFNA group (P 0.05). The total loading time of affected limbs in BHA group was significantly shorter than that in PFNA group, and the difference was statistically significant (P 0.05). The HHS score in BHA group was significantly higher than that in PFNA group at 1 week postoperatively, and the difference was statistically significant (P 0.05). There was no significant difference in HHS score between the two groups half a year after operation (P 0.05). Conclusion both PFNA and BHA are effective methods for the treatment of senile intertrochanteric fracture. Compared with PFNA, BHA has the advantages of less fluoroscopy and faster functional recovery after operation.
【作者单位】：武汉大学人民医院骨关节外科;
【基金】：武汉大学青年教师自资助项目(410500203)
【分类号】：R687.3

【相似文献】