摘要
目的观察股骨近端防旋髓内钉(PFNA)和半髋关节置换(HA)治疗老年不稳定型股骨转子间骨折的临床疗效。方法将31例老年不稳定型股骨转子间骨折患者随机分为PFNA组(16例)和HA组(15例),比较两组临床疗效。结果与HA组相比,PFNA组切口长度小,手术时间短,术中出血量少,但术后卧床时间延长,治疗费用增加(P<0.01)。PFNA组术后1、3个月的Harris髋关节评分低于HA组(P<0.01);而两组术后9个月Harris髋关节评分无统计学差异(P>0.05)。术后PFNA组有1例螺旋刀片切割股骨头,出现轻度髋内翻;HA组有1例伤口脂肪液化,换药后好转。结论 PFNA和HA均为治疗老年股骨转子间骨折的有效方法,术前需行整体评估,以选择最合理的手术方式,取得更佳的临床疗效。
Objective To observe the efficacy of proximal femoral nail antirotation（PFNA） and hemi-arthroplasty（HA） in the treatment of unstable femoral intertrochanteric fracture in elderly patients. Methods Thirty-one cases with unstable inter-trochanteric fractures were randomly assigned into two groups of PFNA（treated with PFNA, 16 cases） and HA（treated with HA, 15 cases）. The clinical outcomes were observed and compared between two groups. Results Compared with group HA,the patients in group PFNA had shorter surgical incision and operation time and less intraoperative blood loss, but longer postoperative bed time and medical costs （P〈0. 01）. Harris hip score of group PFNA was lower than that of group HA in one and 3 monthes after operation（P〈0. 01）, which was not significantly different in 9 monthes postoperatively（P〉0. 05）. There was one case with the femoral nail cutting by spiral blades in group PFNA, which resulted in varus deformity slightly. There was one case with incision fat liquefaction in group HA. Conclusion Both of PFNA and HA are effective in the treatment of unstable femoral intertrochanteric fractures in the elderly. The better efficacy can be obtained by properly choosing the most reasonable way of operation on the basis of overall general assessment.
出处
《江苏医药》
CAS
2016年第18期1980-1982,共3页
Jiangsu Medical Journal
关键词
股骨转子间骨折
股骨近端防旋髓内钉
半髋关节置换
Unstable inter-trochanteric fracture
Proximal femoral nail antirotation
Hemiarthroplasty
