【摘要】 目的探讨股骨近端抗旋转髓内钉(PFNA-Ⅱ)与股骨近端解剖锁定钢板(PFLCP)治疗高龄不稳定型股骨粗隆间骨折的效果。方法回顾性分析2012年6月~2013年12月宝鸡市中心医院97例高龄不稳定型股骨粗隆间骨折患者的临床资料,其中50例患者采用PFNA-Ⅱ内固定(PFNA-Ⅱ固定组),47例患者采用PFLCP内固定(PFLCP固定组)。比较分析两组患者的手术时间、术中出血量、术后下地负重时间、骨折愈合时间、术后1年髋关节功能评分(Harris评分)及相关并发症发生情况等。结果 97例患者均顺利完成手术,随访时间6~15个月,平均(10.23±4.26)个月。PFNA-Ⅱ固定组在手术时间(t=24.88,P<0.01)、术中失血量(t=77.72,P<0.01)、术后下地时间(t=14.73,P<0.01)及相关并发症(χ~2=4.44,P<0.05)方面均优于PFLCP固定组,而在骨折愈合时间(t=1.82,P>0.05)及术后Harris评分优良率(χ~2=1.15,P>0.05)方面差异无统计学意义。结论 PFNA-Ⅱ具有操作简单、创伤小、骨折固定牢靠、符合生物学固定原则、并发症少及患者可早期离床负重等优点,是治疗股骨粗隆间骨折的理想方法,尤其适合高龄不稳定型患者。更多还原

【Abstract】 Objective To discuss the clinical efficacy of proximal femoral anti-rotation nail(PFNA-Ⅱ) and proximal femoral locking compress plate(PFLCP) in the treatment of unstable femoral intertrochanteric fracture in the elderly.Methods From June 2012 to December 2013,clinical data of 97 elderly patients with unstable femoral intertrochanteric fracture in the Central Hospital of Baoji City were retrospectively analyzed,there were 50 cases in PFNA-Ⅱ internal fixation(PFNA-Ⅱ group),while 47 cases in PFLCP internal fixation(PFLCP group).Operation time,intraoperative blood loss,time of postoperation weight loading,fracture healing time,Harris hip scores one year after operation and related complications were comparatively analyzed.Results All patients were operated successfully,and were followed up for 6-15 months,with average(10.23±4.26) months.Compared with PFNA-Ⅱ group,the operative time(t = 24.88,P < 0.01),intraoperative blood loss(t = 77.72,P < 0.01),time of postoperation weight loading(t = 14.73,P < 0.01) and related complication(χ~2= 4.44,P < 0.05) were better than those of the PFLCP group,however,there was no significant difference in healing time(t = 1.82,P > 0.05) and Harris hip score(χ~2= 1.15,P > 0.05) between two groups.Conclusion PFNA-Ⅱ fixation of intertrochanteric fracture has the advantages of simple operation,limited invasion,in accordance with the principle of biological fixation,stable fixation,less complications,and patients can get out of bed early weight-bearing,which is especially suitable for elderly patients.更多还原