老年股骨粗隆间骨折PFNA和PFN内固定疗效比较

发布时间：2018-06-04 10:08

本文选题：股骨骨折 + 骨折固定术　；参考：《中国骨科临床与基础研究杂志》2016年05期

【摘要】：目的探讨应用股骨近端防旋髓内钉(PFNA)和股骨近端髓内钉(PFN)治疗老年股骨粗隆间骨折的疗效差异。方法选取2013年1月至2015年6月梅州市大埔县人民医院收治的120例老年股骨粗隆间骨折患者,根据内固定方式的不同,按随机数字表法分为PFN组(59例)和PFNA组(61例),分别采用PFN和PFNA进行内固定。记录两组手术时间、术中出血量、骨折愈合时间和并发症发生情况,评估患者末次随访髋关节功能恢复情况及患者满意度。结果 PFN组和PFNA组的手术时间分别为(95±14)min和(62±12)min,两组比较,差异有统计学意义(P0.05);术中出血量分别为(140±18)mL和(138±20)mL,两组比较,差异无统计学意义(P0.05)。随访时间12~24个月,平均随访时间18.6个月。PFNA组骨折愈合时间、末次随访髋关节Harris评分优良率及患者满意度均与PFN组相似(P0.05),但两组并发症发生率比较,差异有统计学意义(P0.05)。结论 PFN和PFNA内固定治疗老年股骨粗隆间骨折均能取得满意的临床疗效,但PFNA手术时间更短,术后并发症更少,术者在选择治疗方案时可综合考虑。
[Abstract]:Objective to explore the difference of treatment effect between proximal femoral intramedullary nail (PFNA) and proximal femoral intramedullary nail (PFN) in elderly patients with femoral intertrochanteric fracture. Methods from January 2013 to June 2015, 120 elderly patients with intertrochanteric fracture of femur were treated in Taipu County people's Hospital of Meizhou City, according to different internal fixation methods. PFN group (59 cases) and PFNA group (61 cases) were randomly divided into two groups. PFN and PFNA were used for internal fixation, respectively. The operative time, intraoperative bleeding, fracture healing time and complications were recorded, and hip function recovery and patient satisfaction were evaluated. Results the operative time of PFN group and PFNA group were 95 卤14)min and 62 卤12min, respectively, the difference was statistically significant (P 0.05), the amount of intraoperative bleeding was 140 卤18)mL and 138 卤20mL, respectively. There was no significant difference between the two groups (P 0.05). The average follow-up time was 18.6 months. The excellent and good rate of hip joint Harris score and patient satisfaction in the last follow-up were similar to those in the PFN group (P 0.05). However, there was significant difference in the incidence of complications between the two groups (P 0.05). Conclusion both PFN and PFNA internal fixation can achieve satisfactory clinical effect in the treatment of intertrochanteric fracture of the femur in the elderly, but the operation time of PFNA is shorter and the postoperative complications are less.
【作者单位】：大埔县人民医院骨科;
【分类号】：R687.3

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