股骨近端防旋髓内钉与股骨近端锁定钢板治疗老年股骨转子间骨折的疗效比较
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摘要
目的比较股骨近端防旋髓内钉(PFNA)与股骨近端锁定钢板(LPFP)治疗老年股骨转子间骨折的疗效。方法将80例老年股骨转子间骨折患者随机分为2组,LPFP组给予LPFP,PFNA组给予PFNA,比较2组患者围术期临床指标、Harris评分、并发症与远期预后。结果 PFNA组患者围术期临床指标均显著优于LPFP组(P <0. 05);治疗后12个月,PFNA组Harris评分显著高于LPFP组(P <0. 05); PFNA组感染、下肢静脉血栓与髋内翻发生率均显著低于LPFP组(P <0. 05);PFNA组治疗后12个月生理功能、身体疼痛、活力与社会功能评分均显著高于LPFP组(P <0. 05)。结论相较于LPFP,PFNA对老年股骨转子间骨折患者的创伤更小,安全性更高。
Objective To compare the efficacy of proximal femoral anti-rotation intramedullary nail(PFNA) and proximal femoral locking plate(LPFP) in the treatment of elderly patients with intertrochanteric femoral fracture. Methods A total of 80 elderly patients with femoral intertrochanteric fractures were randomly divided into two groups. LPFP group was treated with LPFP,and PFNA group was treated with PFNA. The perioperative indexes,Harris score,complications and long-term prognosis were compared between two groups. Results The perioperative indicators of the PFNA group were significantly better than those of the LPFP group(P < 0. 05). After 12 months of treatment,the Harris score of the PFNA group was significantly higher than that of the LPFP group(P <0. 05). The incidence rates of infection,venous thrombosis of lower extremities and hip varus in the PFNA group were significantly lower than those in the LPFP group(P < 0. 05). After 12 months of treatment,the scores of physiological function,body pain,vitality and social function in the PFNA group were significantly higher than those in LPFP group(P < 0. 05). Conclusion Compared with LPFP,PFNA is more safe for elderly patients with femoral intertrochanteric fractures,which can cause less trauma.
Objective To compare the efficacy of proximal femoral anti-rotation intramedullary nail(PFNA) and proximal femoral locking plate(LPFP) in the treatment of elderly patients with intertrochanteric femoral fracture. Methods A total of 80 elderly patients with femoral intertrochanteric fractures were randomly divided into two groups. LPFP group was treated with LPFP,and PFNA group was treated with PFNA. The perioperative indexes,Harris score,complications and long-term prognosis were compared between two groups. Results The perioperative indicators of the PFNA group were significantly better than those of the LPFP group(P < 0. 05). After 12 months of treatment,the Harris score of the PFNA group was significantly higher than that of the LPFP group(P <0. 05). The incidence rates of infection,venous thrombosis of lower extremities and hip varus in the PFNA group were significantly lower than those in the LPFP group(P < 0. 05). After 12 months of treatment,the scores of physiological function,body pain,vitality and social function in the PFNA group were significantly higher than those in LPFP group(P < 0. 05). Conclusion Compared with LPFP,PFNA is more safe for elderly patients with femoral intertrochanteric fractures,which can cause less trauma.
引文
[1]彭涛,寿康全,付纳新,等. 3种方法治疗老年不稳定性股骨转子间骨折的疗效比较[J].临床骨科杂志,2015,18(2):187-190.
[2]时超,罗仲伟,陈继平,等.不同内固定治疗股骨转子间骨折104例疗效分析[J].实用临床医药杂志,2016,20(17):116-117,120.
[3]段显亮,程维,孙波,等. 3种内固定治疗股骨转子间骨折患者的疗效对比[J].中国老年学杂志,2014,34(16):4557-4559.
[4]李营营,李芝慧,李方,等.电针结合康复训练对早期股骨头坏死患者髋关节功能和生活质量的影响[J].中华物理医学与康复杂志,2014,36(2):132-135.
[5]孙强,许平安,郑加法.三种手术方式固定不稳定性股骨转子间骨折的生物力学研究[J].中华创伤杂志,2012,28(12):1078-1082.
[6]沈勇灵,陈爱民,刘世杰,等.三种内固定方法治疗老年股骨转子间骨折的临床分析[J].微创医学,2015,10(6):811-813.
[7]陈来,刘林,叶灵超,等.股骨近端锁定钢板与髓内钉-螺旋刀片内固定治疗60岁以上股骨转子间骨折的对比研究[J].中华全科医师杂志,2014,13(11):910-913.
[8]独行业,周正明,殷小军,等.股骨近端防旋髓内钉在股骨转子间骨折内固定失效翻修中的应用[J].中华创伤杂志,2015,31(1):45-49.
[9] Tang S L,Jiang C. Comparison of the effect of inverted less invasive stabilization system(LISS)and proximal femoral nail anti-rotation(PFNA)in the treatment of complex unstable intertrochanteric fracture in aged[J]. Zhongguo gu shang,2011,24(5):366-369.
[10]苏嘉,沈新升,季日旭,等.三种内固定方法治疗老年股骨转子间骨折的疗效比较[J].浙江实用医学,2016,21(3):184-186.
[11]陈绍站,许勇,李婧,等.防旋股骨近端髓内针与股骨近端解剖锁定钢板治疗转子间骨折的疗效比较[J].临床外科杂志,2016,24(10):787-788,789.
[12]李栋,丁彬,赵一贫. PFNA与LPFP治疗老年股骨转子间骨折的临床疗效比较分析[J].浙江创伤外科,2014,19(5):764-765.
[13]张兆飞,刘志祥,杨俊龙,等. PFNA-Ⅱ与股骨近端解剖锁定钢板在治疗股骨转子间骨折疗效分析[J].吉林医学,2016,37(3):557-559.
[14] Zhu L J,Li X F,Liu C,et al. Clinical analysis of LPFP,PFNA and BPH in treating femoral intertrochanteric fractures in elderly patients[J]. Zhongguo gu shang,2017,30(7):607-611.
[15]张磊,周正明,顾家烨,等.经皮加压钢板与股骨近端防旋髓内钉内固定治疗老年稳定性股骨转子间骨折:术后功能恢复、股骨头旋转及固定钉滑脱的比较[J].中国组织工程研究,2017,21(31):4995-5000.
[16]于铁淼,苗会玲.骨水泥型与生物型髋关节假体置入修复老年不稳定股骨转子间骨折的疗效及安全性:前瞻性、非随机对照临床试验[J].中国组织工程研究,2017,21(15):2308-2313.
[17]侯立刚.不同方式重建股骨矩在老年股骨转子间骨折人工关节置换中的生物力学分布[J].中国组织工程研究,2017,21(23):3616-3621.
[18]江海良,郭开今,王翔,等.生物型与骨水泥型假体半髋置换治疗老年不稳定性股骨转子间骨折的比较[J].中国组织工程研究,2017,21(23):3622-3627.
[19]刘凌翔,高雯,李军,等. 497例子宫内膜癌的临床诊断治疗以及预后因素分析[J].实用临床医药杂志,2016,20(7):86-89.
[20]朱浩,夏青,朱如里,等.不同内固定方式治疗股骨转子间骨折的效果比较[J].南通大学学报:医学版,2015,35(4):313-315.
[2]时超,罗仲伟,陈继平,等.不同内固定治疗股骨转子间骨折104例疗效分析[J].实用临床医药杂志,2016,20(17):116-117,120.
[3]段显亮,程维,孙波,等. 3种内固定治疗股骨转子间骨折患者的疗效对比[J].中国老年学杂志,2014,34(16):4557-4559.
[4]李营营,李芝慧,李方,等.电针结合康复训练对早期股骨头坏死患者髋关节功能和生活质量的影响[J].中华物理医学与康复杂志,2014,36(2):132-135.
[5]孙强,许平安,郑加法.三种手术方式固定不稳定性股骨转子间骨折的生物力学研究[J].中华创伤杂志,2012,28(12):1078-1082.
[6]沈勇灵,陈爱民,刘世杰,等.三种内固定方法治疗老年股骨转子间骨折的临床分析[J].微创医学,2015,10(6):811-813.
[7]陈来,刘林,叶灵超,等.股骨近端锁定钢板与髓内钉-螺旋刀片内固定治疗60岁以上股骨转子间骨折的对比研究[J].中华全科医师杂志,2014,13(11):910-913.
[8]独行业,周正明,殷小军,等.股骨近端防旋髓内钉在股骨转子间骨折内固定失效翻修中的应用[J].中华创伤杂志,2015,31(1):45-49.
[9] Tang S L,Jiang C. Comparison of the effect of inverted less invasive stabilization system(LISS)and proximal femoral nail anti-rotation(PFNA)in the treatment of complex unstable intertrochanteric fracture in aged[J]. Zhongguo gu shang,2011,24(5):366-369.
[10]苏嘉,沈新升,季日旭,等.三种内固定方法治疗老年股骨转子间骨折的疗效比较[J].浙江实用医学,2016,21(3):184-186.
[11]陈绍站,许勇,李婧,等.防旋股骨近端髓内针与股骨近端解剖锁定钢板治疗转子间骨折的疗效比较[J].临床外科杂志,2016,24(10):787-788,789.
[12]李栋,丁彬,赵一贫. PFNA与LPFP治疗老年股骨转子间骨折的临床疗效比较分析[J].浙江创伤外科,2014,19(5):764-765.
[13]张兆飞,刘志祥,杨俊龙,等. PFNA-Ⅱ与股骨近端解剖锁定钢板在治疗股骨转子间骨折疗效分析[J].吉林医学,2016,37(3):557-559.
[14] Zhu L J,Li X F,Liu C,et al. Clinical analysis of LPFP,PFNA and BPH in treating femoral intertrochanteric fractures in elderly patients[J]. Zhongguo gu shang,2017,30(7):607-611.
[15]张磊,周正明,顾家烨,等.经皮加压钢板与股骨近端防旋髓内钉内固定治疗老年稳定性股骨转子间骨折:术后功能恢复、股骨头旋转及固定钉滑脱的比较[J].中国组织工程研究,2017,21(31):4995-5000.
[16]于铁淼,苗会玲.骨水泥型与生物型髋关节假体置入修复老年不稳定股骨转子间骨折的疗效及安全性:前瞻性、非随机对照临床试验[J].中国组织工程研究,2017,21(15):2308-2313.
[17]侯立刚.不同方式重建股骨矩在老年股骨转子间骨折人工关节置换中的生物力学分布[J].中国组织工程研究,2017,21(23):3616-3621.
[18]江海良,郭开今,王翔,等.生物型与骨水泥型假体半髋置换治疗老年不稳定性股骨转子间骨折的比较[J].中国组织工程研究,2017,21(23):3622-3627.
[19]刘凌翔,高雯,李军,等. 497例子宫内膜癌的临床诊断治疗以及预后因素分析[J].实用临床医药杂志,2016,20(7):86-89.
[20]朱浩,夏青,朱如里,等.不同内固定方式治疗股骨转子间骨折的效果比较[J].南通大学学报:医学版,2015,35(4):313-315.