PFNA与InterTAN治疗老年骨质疏松性不稳定型股骨转子间骨折的回顾性分析

发布时间：2018-09-15 18:55

【摘要】：目的本临床研究的目的是回顾性评价PFNA与InterTAN治疗老年骨质疏松性不稳定型股骨转子间骨折的临床疗效,通过分析临床数据和讨论两种内固定的特点,以比较两种内固定方式在临床运用中的优劣性。方法(1)分组：收集2013年6月—2014年12月四川省人民医院骨科住院的且满足纳入标准的老年骨质疏松性不稳定型股骨转子间骨折37例患者。(2)方法：19例患者采用PFNA治疗,18例患者采用InterTAN治疗,术后两组患者均给予同样的治疗方法和功能康复。(3)观察内容：比较两组患者的手术时间、术中出血量、术后引流量、切口长度、住院时间、骨折临床愈合时间、内固定稳定性以及术后髋关节功能Harris评分。结果术后随访3个月～15个月,平均9.6个月。(1)通过比较手术时间、术中出血量、术后引流量及骨折临床愈合时间,可以得出两组数据有差异(P0.05),具有统计学意义,说明了PFNA组比InterTAN组手术时间短、术中出血少及术后引流量少,InterTAN组比PFNA组骨折临床愈合时间短。(2)在内固定稳定性方面,PFNA组出现1例螺旋刀片退出,InterTAN组无螺钉退出,但两组数据差异无统计学意义(P0.05),这可能与收集的病例数量不多有关,需要进一步大样本研究,因此InterTAN比PFNA的稳定性可能更好。(3)通过比较切口长度、住院时间及术后髋关节功能Harris评分,可以得出两组数据无差异(P0.05),不具有统计学意义,说明了PFNA组与InterTAN组在切口长度、住院时间及术后髋关节功能Harris评分方面相近。结论(1)在老年骨质疏松性不稳定型股骨转子间骨折的治疗上,PFNA与InterTAN都是安全有效的内固定方式,均具有手术创伤小、术中出血量少、术后引流量少、骨折固定牢靠、住院时间短及功能恢复好的优点。(2)PFNA与InterTAN相互比较,又各有优缺点。与InterTAN比较,PFNA的术中操作更加简洁方便、手术时间更短、术中出血量更少及术后引流量更少。与PFNA比较,InterTAN的骨折临床愈合时间更短及稳定性可能更好。
[Abstract]:Objective to evaluate the clinical efficacy of PFNA and InterTAN in the treatment of unstable femoral intertrochanteric fracture in elderly patients, and to analyze the clinical data and discuss the characteristics of two internal fixation methods. To compare the advantages and disadvantages of two internal fixation methods in clinical application. Methods (1) A total of 37 elderly patients with unstable femoral intertrochanteric fractures were collected from orthopaedic department of Sichuan Provincial people's Hospital from June 2013 to December 2014. (2) methods: 19 patients were treated with PFNA. 18 patients were treated with InterTAN. The two groups were given the same treatment method and functional rehabilitation. (3) observation: the operation time, intraoperative blood loss, postoperative drainage, incision length, hospital stay, fracture clinical healing time were compared between the two groups. Stability of internal fixation and Harris score of hip function after operation. Results the postoperative follow-up ranged from 3 months to 15 months with an average of 9.6 months. (1) by comparing the operative time, intraoperative bleeding volume, postoperative drainage volume and fracture healing time, the data of the two groups were significantly different (P0.05). The results showed that the operation time of PFNA group was shorter than that of InterTAN group, and the healing time of intern group was shorter than that of PFNA group. However, the difference between the two groups was not statistically significant (P0.05), which may be related to the small number of cases collected, so the stability of InterTAN may be better than that of PFNA. (3) by comparing the length of incision, Hospitalization time and postoperative hip function Harris score, can be obtained two groups of data have no difference (P0.05), there is no statistical significance, indicating that PFNA group and InterTAN group in incision length, hospitalization time and postoperative hip function Harris score is similar. Conclusion (1) both InterTAN and PFNA are safe and effective internal fixation methods in the treatment of unstable femoral intertrochanteric fractures in the elderly. Both have the advantages of less operative trauma, less intraoperative bleeding, less postoperative drainage and reliable fixation. The advantages of short hospitalization time and good functional recovery. (2) compared with InterTAN, PFNA has its own advantages and disadvantages. Compared with InterTAN, the intraoperative operation was more simple and convenient, the operation time was shorter, the amount of intraoperative bleeding was less and the postoperative drainage was less. The clinical healing time and stability of intertan fracture were shorter and more stable than PFNA.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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