摘要
目的比较股骨近端防旋髓内钉系统(PFNA)和股骨近端解剖型锁定钢板(ALP)治疗不稳定型股骨粗隆间骨折的临床疗效。方法选取哈励逊国际和平医院收治的不稳定型股骨粗隆间骨折患者86例,根据手术方式的不同分为PFNA组48例和ALP组38例。比较两组患者的术口长度、手术时间、术中出血量、术后开始负重站立时间、骨折愈合时间、术后并发症的发生情况及治疗9个月后的Harris评分与疗效。结果 PFNA组的术口长度为(6.76±2.03)cm,手术时间为(58.03±15.95)min,术中出血量为(81.84±47.26)ml,术后开始负重站立时间为(25.37±6.08)d,均显著少于ALP组(P<0.05);两组患者的骨折愈合时间比较,无统计学差异(P>0.05)。PFNA组术后并发症发生率为4.17%,ALP组为20.21%,PFNA组的术后并发症发生率显著低于ALP组(P<0.05)。PFNA组的Harris评分为(86.75±7.19)分,优良率为93.75%,而ALP组为(84.38±6.09)分及92.11%,两组比较,差异没有统计学意义(P>0.05)。结论 PFNA和ALP治疗不稳定型股骨粗隆间骨折均有良好的疗效,但PFNA的手术创伤更小、固定强度更好、术后并发症更少。
【Objective】To compare the clinical efficacy of proximal femoral nail anti-rotation（PFNA） and anatomic proximal femoral locking plate（ALP） in the treatment of unstable femoral intertrochanteric fractures.【Methods】Eighty-six patients with unstable femoral intertrochanteric fractures in our hospital were selected and divided into two groups according to the operation methods. 48 cases were treated with PFNA and 38 cases with ALP. The incision length, operation time, amount of bleeding, postoperative weight-bearing standing time, fracture healing time,postoperative complications, and Harris score and efficacy 9 months after the operation were compared.【Results】In the subjects of the PFNA group, the incision length [（6.76±2.03） cm], operation time [（58.03±15.95） min], amount of bleeding [（81.84±47.26） ml], postoperative weight-bearing standing time [（25.37±6.08） d], were all significantly less than those of the subjects in the ALP group（all P〈0.05）. The difference of fracture healing time between the two groups was not significantly different（P〉0.05）. The complication rate of the PFNA group（4.17%） was significantly lower than that in the ALP group（20.21%, P〈0.05）. The Harris score and the excellent and good rate of the PFNA group were（86.75±7.19） and 93.75%, while those of the ALP group were（84.38±6.09） and 92.11%. The differences between the two groups were not statistically significant（P all 〉0.05）.【Conclusions】 PFNA and ALP are effective in the treatment of unstable femoral intertrochanteric fractures and the PFNA is less invasive with better fixation strength and fewer postoperative complications.
出处
《中国现代医学杂志》
CAS
北大核心
2015年第6期61-65,共5页
China Journal of Modern Medicine
关键词
股骨近端防旋髓内钉系统
股骨近端解剖型锁定钢板
不稳定型股骨粗隆间骨折
proximal femoral nail anti-rotation（PFNA）
anatomic proximal femoral locking plate（ALP）
unstable femoral intertrochanteric fractures
