两种体位下PFNA内固定术治疗股骨转子间骨折的临床疗效观察

目的：探讨在平卧位牵引床与侧卧位普通床下应用PFNA内固定治疗股骨转子间骨折的临床疗效与安全性。方法：回顾性分析2009年9月-2013年4月本院有完整随访资料的患者共57例，其中采用平卧位牵引床患者35例，普通手术床健侧卧位22例，比较两组患者的体位摆放时间、手术时间、术中显性失血量、切口总长度、术后骨折复位程度以及1、3、6个月髋关节功能Harris评分方面的差异。结果：随访6-16个月，平均12.8个月；两组术中显性出血量、切口长度、术后髋关节功能评分的比较差异均无统计学意义（P〉0.05）；而侧卧位组的体位摆放时间、手术时间短于平卧位组（P〈0.05）；复位程度上，平卧位组优于侧卧位组（P〈0.05）。结论：侧卧位及平卧位均适于股骨转子间骨折行PFNA内固定，实践中可根据手术医师及患者的个体特点选择应用，侧卧位更适合身材肥胖、下肢短缩的患者。

The Clinical Efficacy of PFNA Internal Fixation in the Treatment for Femoral Intertrochanteric Fractures in the Two Position

Objective：To study the clinical efficacy and safety in different position of PFNA for the clinical treatment of intertrochanteric fractures. Method：57 patients with complete follow-up data in our hospital were randomly divided into two groups through the retrospective analysis from September 2009 to April 2013. The control group（n=22）was taken lateral position in ordinary operation bed,the treatment group was taken supine position in traction bed. The differences between the two groups in position time,surgical time,intraoperative blood loss,the total length of incision,the degree of reduction of fracture after operation and the function of hip joint by Harris score of 1,3,6 months were compared. Result：57 patients were followed up for 6 to 16 months,an average of 12.8 months. There were not statistical significant difference in blood loss,the total length of incision and Harris hip score system of two groups（P〈0.05）. There were statistical significant differences of operative time,position time and the reduction degree（P〈0.05）. Conclusion：The two kinds of postures are both effective treatment of intertrochanteric fractures. And the lateral position is more suitable for fat,lower limb shortening patients.