股骨近端防旋髓内钉与股骨近端解剖锁定板治疗中老年股骨转子间骨折
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  • 英文篇名:Proximal femoral nail anti-rotation and anatomic proximal femoral locking plate in the treatment of intertrochanteric fractures in middle-aged and elderly patients
  • 作者:潘杨 ; 陈泉 ; 谭云 ; 朱政炜 ; 刘小林
  • 英文作者:PAN Yang;CHEN Quan;TAN Yun;ZHU Zheng-wei;LIU Xiao-lin;Section Ⅱ,Dept of Orthopaedics,Shizhu Tujia Autonomous County People's Hospital of Chongqing City;
  • 关键词:股骨骨折 ; 骨折固定术 ; 股骨近端防旋髓内钉 ; 股骨近端解剖锁定板
  • 英文关键词:femoral fractures;;fracture fixation;;proximal femoral intramedullary nailing;;anatomic proximal femoral locking plate
  • 中文刊名:LCGK
  • 英文刊名:Journal of Clinical Orthopaedics
  • 机构:重庆市石柱土家族自治县人民医院骨二科;
  • 出版日期:2019-04-26
  • 出版单位:临床骨科杂志
  • 年:2019
  • 期:v.22
  • 语种:中文;
  • 页:LCGK201902037
  • 页数:3
  • CN:02
  • ISSN:34-1166/R
  • 分类号:102-104
摘要
目的比较股骨近端防旋髓内钉(PFNA)和股骨近端解剖锁定板(APFLP)治疗中老年股骨转子间骨折的疗效。方法将60例中老年股骨转子间骨折患者根据内固定方式不同分为PFNA组(38例)与APFLP组(22例)。比较两组患者的切口长度、手术时间、术中出血量、骨折愈合时间、并发症以及末次随访髋关节Harris评分。结果 PFNA组的切口长度、手术时间、术中出血量均小(少)于APFLP组,差异均有统计学意义(P <0. 05)。60例均获得随访,时间14~25个月。PFNA组出现大腿疼痛1例; APFLP组出现螺钉松动、钢板断裂、创口感染各1例。两组的并发症发生率、髋关节Harris评分及优良率比较差异均无统计学意义(P>0. 05)。结论 PFNA和APFLP治疗中老年股骨转子间骨折均能取得良好的疗效,应根据患者个体情况合理选择。PFNA适应证更广,切口更小,手术时间更短,术中出血量更少。
        Objective To compare the clinical efficacy of proximal femoral nail anti-rotation( PFNA) and anatomic proximal femoral locking plate( APFLP) in the treatment of intertrochanteric fractures. Methods The 60 intertrochanteric fractures were treated with surgery,of which 38 cases were treated by PFNA,22 cases were treated by APFLP. The length of incision,operation time,intraoperative bleeding volume,fracture healing time,complication and the hip Harris score in the final follow-up were compared in two groups. Results The incision length,operation time,intraoperative bleeding volume of the PFNA group were less( shorter) than those of the APFLP group,the differences were statistically significant( P < 0. 05). The 60 patients were followed up for 14 ~ 25 months. One patient of thigh pain occurred in PFNA group. There was 1 case of screw loosening,plate breakage and wound infection in APFLP group separately. There were no statistically significant differences between the two groups in the complications incidence rate,the hip Harris score and excellent-good rate( P > 0. 05). Conclusions PFNA and APFLP both can obtain good curative effect,reasonable choice should be made according to the individual condition of the patient. The PFNA has the advantages of wider indications,smaller incision length,shorter operation time and less intraoperative bleeding.
引文
[1]刘洪业,付国建.髓内和髓外固定治疗老年股骨转子间骨折的疗效比较[J].临床骨科杂志,2017,20(6):730-732.
    [2]黄凯,陈安富.两种内固定手术治疗老年股骨转子间骨折的隐性失血量及预后比较[J].空军医学杂志,2016,32(4):261-263,269.
    [3]余建,赵奎,王华,等.股骨近端防旋髓内钉治疗股骨转子间骨折疗效分析[J].临床骨科杂志,2018,21(2):196-197.
    [4]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.
    [5] Westacott D,Bould M. Outcome in 36 elderly patients treated with the Gamma3 long nail for unstable proximal femoral fracture[J].Acta Orthop Belg,2011,77(1):68-72.
    [6] Mereddy P,Kamath S,Ramakrishnan M,et al. The AO/ASIF proximal femoral nail antirotation(PFNA):a new design for the treatment of unstable proximal femoral fractures[J]. Injury,2009,40(4):428-432.

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