INTERTAN髓内钉与PFNA-Ⅱ髓内钉治疗老年股骨粗隆间骨折临床研究
发布时间：2019-06-19 03:43
【摘要】：目的回顾性分析INTERTAN髓内钉与PFNA-Ⅱ髓内钉治疗老年股骨粗隆间骨折临床效果。方法自2010年10月至2014年8月我科收治128例老年股骨粗隆间骨折患者,骨折分型按照AO分型标准进行分类,50例为A1型、57例为A2型及21例为A3型。69例应用Smith㤘Nephew公司INTERTAN髓内钉治疗,59例采用Synthes公司PFNA-Ⅱ髓内钉治疗。比较两组患者手术时间、术中出血量、切口长度、术后输血例数及输血量、骨折愈合时间、内固定失效例数、术后3个月大腿疼痛程度及末次随访髋关节功能Harris评分。两组数据计量资料(手术时间、术中出血量、切口长度、术后输血量、骨折愈合时间)采用t检验,计数资料(术后输血例数、内固定失效例数、术后3个月大腿疼痛程度、Harris评分)采用卡方检验进行统计分析,结果所有患者获得8~16个月随访,平均(10.33±2.75)个月。PFNA-Ⅱ组在手术时间[(50.00±7.82)min]、术中出血量[(74.00±48.35)ml]、术后输血量[(1.60±0.70)U]较INTERTAN组少,INTERTAN组内固定失败6例少于PFNA-Ⅱ组失败1例(P0.05),两组切口长度[INTERTAN组(4.00±0.94)cm、PFNA-Ⅱ组(3.80±0.79)cm]、骨折愈合时间[INTERTAN组(5.20±0.92)个月、PFNA-Ⅱ组(5.30±0.95)个月]、术后输血例数(INTERTAN组41例、PFNA-Ⅱ组38例)、术后3个月大腿疼痛程度(INTERTAN组2例、PFNA-Ⅱ组5例)和末次随访髋关节功能Harris评分(INTERTAN组优45例、良19例、可3例、差2例,PFNA-Ⅱ组优35例、良15例、可5例、差4例)均无明显差异(P0.05)。结论 PFNA-Ⅱ及INTERTAN均为髓内固定,符合微创理念,另各具有优势,PFNA-Ⅱ操作相对简单,适用于内科合并症多的老年不易长时间手术者,INTERTAN实践中更具有良好的生物力学优势及稳定性,减少患者术后大腿疼痛。临床中对于反粗隆间骨折,建议应用加长髓内钉固定,减少局部应力集中及再骨折风险,A2.2以上不稳定型骨折优选INTERTAN髓内钉,减少头钉切割。
[Abstract]:Objective to analyze the clinical effect of INTERTAN intramedullary nail and PFNA- II intramedullary nail in the treatment of intertrochanteric fracture of femur in the elderly. Methods from October 2010 to August 2014, 128 elderly patients with intertrochanter fracture were classified according to AO classification standard. 50 cases were A1 type, 57 cases were A2 type and 21 cases were A3 type. 69 cases were treated with INTERTAN intramedullary nail of Smith?Nephew Company and 59 cases were treated with PFNA- II intramedullary nail of Synthes Company. The operation time, intraoperative blood loss, incision length, postoperative blood transfusion, fracture healing time, failure of internal fixation, thigh pain 3 months after operation and Harris score of hip joint function in the last follow-up were compared between the two groups. The data of the two groups (operation time, intraoperative blood loss, incision length, postoperative blood transfusion, fracture healing time) were analyzed by t test, counting data (postoperative blood transfusion, failure of internal fixation, degree of thigh pain 3 months after operation, Harris score). The results showed that all patients were followed up for 8 to 16 months. The mean time of operation [(50.00 卤7.82) min], the amount of intraoperative blood loss [(74.00 卤48.35) ml], the postoperative transfusion volume [(1.60 卤0.70) U] were less than those in INTERTAN group, the failure of internal fixation in INTERTAN group was less than that in PFNA- 鈪，
本文编号：2502051
[Abstract]:Objective to analyze the clinical effect of INTERTAN intramedullary nail and PFNA- II intramedullary nail in the treatment of intertrochanteric fracture of femur in the elderly. Methods from October 2010 to August 2014, 128 elderly patients with intertrochanter fracture were classified according to AO classification standard. 50 cases were A1 type, 57 cases were A2 type and 21 cases were A3 type. 69 cases were treated with INTERTAN intramedullary nail of Smith?Nephew Company and 59 cases were treated with PFNA- II intramedullary nail of Synthes Company. The operation time, intraoperative blood loss, incision length, postoperative blood transfusion, fracture healing time, failure of internal fixation, thigh pain 3 months after operation and Harris score of hip joint function in the last follow-up were compared between the two groups. The data of the two groups (operation time, intraoperative blood loss, incision length, postoperative blood transfusion, fracture healing time) were analyzed by t test, counting data (postoperative blood transfusion, failure of internal fixation, degree of thigh pain 3 months after operation, Harris score). The results showed that all patients were followed up for 8 to 16 months. The mean time of operation [(50.00 卤7.82) min], the amount of intraoperative blood loss [(74.00 卤48.35) ml], the postoperative transfusion volume [(1.60 卤0.70) U] were less than those in INTERTAN group, the failure of internal fixation in INTERTAN group was less than that in PFNA- 鈪，
本文编号：2502051
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