摘要
目的比较股骨近端防旋髓内钉（PFNA）与亚洲型PFNA（PFNA-Ⅱ）固定治疗股骨转子间骨折的临床疗效。方法回顾性分析2009年5月至2014年7月采用PFNA或PFNA-Ⅱ内固定治疗且获得随访的54例股骨转子间骨折患者资料，根据不同时间段采用内固定物不同分为两组：PFNA组27例，2009年5月至2011年11月期间采用PFNA固定；PFNA-Ⅱ组27例，2011年12月至2014年7月采用PFNA-Ⅱ固定。比较两组患者的手术时间、显性失血量、隐性失血量、术中及术后并发症发生情况、骨折愈合时间及末次随访时髋关节Harris评分等。结果PFNA组与PFNA-Ⅱ组患者的随访时间平均分别为（22．6±4．8）、（19．5±4．6）个月。PFNA组患者显性失血量[（130．1±74．3）mL]显著多于PFNA-Ⅱ组患者[（46．3±23．1）mL]，术中医源性股骨近端外侧壁骨折发生率（18．5％，5／27）、术后大腿外侧软组织激惹发生率（22．2％，6／27）、术后大腿中段痛发生率（22．2％，6／27）显著高于PFNA-Ⅱ组患者[0，3．7％（1／27），3．7％（1／27）]，差异均有统计学意义（P〈0．05）。两组患者的手术时间、隐性失血量、术后内科并发症发生率、骨折愈合时间、末次随访时髋关节Harris评分比较差异均无统计学意义（P〉0．05）。结论与PFNA固定比较，PFNA—Ⅱ固定术中出血量少，术中、术后内固定相关并发症发生率低。
Objective To compare the clinical effects of proximal femoral nail antirotation （PFNA） and proximal femoral nail antirotation- Ⅱ （PFNA- Ⅱ） in the internal fixation of femoral intertrochanteric fracture. Methods A retrospective study was conducted of the 54 patients with femoral intertrochanteric fracture who had been treated at our department from May 2009 through July 2014. During May 2009 and November 2011, 27 of them were treated with PFNA; during December 2011 and July 2014, the other 27 of them were treated with PFNA - Ⅱ. The 2 groups were compared in terms of operation time, intraoperative blood loss volume, hidden blood loss volume, intraoperative and postoperative complications, fracture healing time and Harris hip score at the last follow-up. Results In the PFNA group, 27 patients were followed up for an average time of 22. 6 ± 4. 8 months. In the PFNA-Ⅱ group, 27 patients were followed up for an average time of 19.5±4.6 months. The PFNA group had significantly more intraoperative blood loss volume （130. 1 ± 74.3 mL）, and significantly higher rates of intraoperative lateral wall fracture of the proximal femur （18.5%, 5/27）, postoperative lateral thigh soft tissue irritation （22. 2%, 6/27） and postoperative thigh pain （22.2%, 6/27） than the PFNA- Ⅱ group [46.3 ± 23.1 mL, 0, 3.7% （1/27）, 3.7% （1/27）, respectively] （P 〈 0. 05）. There were no significant differences between the 2 groups in operation time, hidden blood loss, postoperative complications of internal diseases, fracture healing time, or Harris hip score of last follow-up （ P 〉 0. 05）. Conclusion Compared with PFNA, PFNA- Ⅱ may lead to a smaller volume of intraoperative blood loss and a lower incidence of com- plications related to internal fixation.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2016年第5期435-438,共4页
Chinese Journal of Orthopaedic Trauma
关键词
髋骨折
骨折固定术
髓内
骨钉
Hip fractures
Fracture fixation, intramedullary
Bone nails
