InterTAN钉与PFNA治疗高龄转子间骨折临床对比研究

发布时间：2019-05-21 19:45

【摘要】：目的:对比研究股骨近端防旋髓内钉InterTAN钉与股骨近端防旋髓内钉PFNA,在高龄股骨转子间骨折中的临床疗效及手术技巧。方法:本实验研究了自2014年12月至2016年12月,在我科进行救治的高龄股骨转子间骨折患者,共48例。将患者分为两组,用这两种不同的固定方式分别进行治疗,对比分析这两种不同手术方式疗效。其中InterTAN钉组23例;PFNA组25例。采用InterTAN钉与PFNA这两种手术方式对患者进行治疗。术前术后给予相同治疗手段。对比两组患者之间的一般资料,如伤后至手术间隔时间、手术时间、术中出血量、住院时间、愈合时间及髋关节评分等之间的差异。患者出院后第1、3、6、9、12月于门诊随访,常规给予髋关节正侧位X片,观察骨折愈合情况,通过髋关节Harris功能评分对患者髋关节功能进行评估,从而评价手术疗效。结果:48例患者均获随访评估。InterTAN钉组手术时间80~185min,平均128.7min;术中出血量110~180ml,平均140ml。PFNA组手术时间40~120min,平均68.4min;术中出血量50~110ml,平均83.6ml。术后并发症Inter TAN钉组呼吸系统感染者1例、下肢血栓形成者1例、髋内翻畸形者1例、髋部疼痛者2例;PFNA组呼吸系统感染1例、髋关节内翻畸形2例、髋关节疼痛3例。无伤口红肿感染及脓液渗出、内置物切出股骨颈及内置物断裂等并发症,骨折全部愈合。术后9个月,根据髋关节Harries功能评分标准,InterTAN钉组优12例,良8例,可2例,差1例,优良率为87%;PFNA组优13例,良9例,可1例,差2例,优良率为88%。结论:InterTAN钉与PFNA这两种手术方式对高龄股骨粗隆区骨折患者治疗均有良好的治疗效果,其中PFNA在手术时间和术中出血量方面更有优势。
[Abstract]:Objective: to compare the clinical efficacy and surgical skills of InterTAN nail and PFNA, nail in the treatment of intertrochanter fracture in the elderly. Methods: from December 2014 to December 2016, 48 elderly patients with intertrochanter fracture were treated in our department. The patients were divided into two groups and treated with these two different fixation methods, and the curative effects of these two different surgical methods were compared and analyzed. There were 23 cases in InterTAN nail group and 25 cases in PFNA group. InterTAN nail and PFNA were used to treat the patients. The same treatment was given before and after operation. The general data between the two groups, such as the interval from injury to operation, the time of operation, the amount of intraoperative bleeding, the time of hospitalization, the time of healing and the score of hip joint, were compared. The patients were followed up at 1, 3, 6, 9 and 12 months after discharge. X-rays of the hip joint were given regularly to observe the fracture healing. The hip joint function was evaluated by the hip joint Harris function score, so as to evaluate the curative effect of the operation. Results: all the 48 patients were followed up and evaluated. The operation time was 80 脳 185 min (mean 128.7 min), the intraoperative blood loss was 110 min / 180 ml, the average operation time was 40 min / 120 min (mean 68.4 min), and the intraoperative blood loss was 50 min / 110 ml (mean 83.6 ml). There were 1 case of respiratory infection, 1 case of lower extremity thrombosis, 1 case of hip varus deformity and 2 cases of hip pain in Inter TAN nail group, and 1 case of respiratory infection, 2 cases of hip varus deformity and 3 cases of hip pain in PFNA group. There were no complications such as wound redness, swelling infection and pus exudation, and the fracture healed completely. According to the Harries function score of hip joint, 12 cases were excellent, 8 cases were good, 2 cases were fair and 1 case was poor 9 months after operation. The excellent and good rate was 87% in 13 cases, good in 9 cases, fair in 1 case, poor in 2 cases, and the excellent and good rate was 88%. Conclusion: InterTAN nail and PFNA have good therapeutic effect on elderly patients with trochanter fracture, among which PFNA has more advantages in terms of operation time and intraoperative blood loss.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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