股骨近端锁定钢板与抗旋髓内钉治疗老年股骨转子间骨折的临床研究

目的：探讨应用股骨近端锁定钢板（PF-LCP）与股骨近端抗旋髓内钉（PFNA）治疗老年股骨转子间骨折的手术方法与疗效。方法：选择54例老年股骨转子间骨折患者,按照国际内固定研究学会（AO/ASIF）股骨转子间骨折分类标准（AO31.A1-A3）,分别应用股骨近端锁定钢板（PF-LCP组）或股骨近端抗旋髓内钉（PFNA组）手术方式治疗。记录两组手术时间、术中出血量、术后引流量、骨折愈合时间及关节功能康复情况,并参照Harris评分标准测定髋关节功能。结果：术后48例获得随访,随访时间6～18个月,中位时间12.5个月,其中PF-LCP组25例,PFNA组23例。PFNA组在手术时间、术中出血量、术后引流量均低于PF-LCP组（P〈0.01）,两组骨折愈合时间、关节功能康复（Harris评分）方面差异无统计学意义（P〉0.05）。结论：对于老年股骨转子间骨折应用股骨近端锁定钢板或股骨近端抗旋髓内钉均能获得良好治疗效果,临床应该根据不同骨折类型选择适合的内固定方式。

Clinical study of proximal femoral locking plate and proximal femoral nail antirotation in the treatment of eldly patients with intertrochanteric fracture

Objective ：To investigate surgical methods and efficacy of proximal femoral locking plate and proximal femoral nail antirotation in the treatment of eldly patients with intertrochanteric fracture. Methods： Choose 54 cases of elderly patients with intertrochanteric fractures, according to the Institute of international fixed inside （AO/ASIF） classification of intertrochanteric fracture of femur （ AO31. A1 - A3 ）, treated respectively with proximal femoral locking plate （ PF - LCP group）, proximal femoral nail antirotation （ PFNA group ）. Recorded two groups of operation time, bleeding volume, postoperative drainage volume, healing time of fracture and joint function rehabilitation, and determined the hip joint function according to Harris score standard. Results： After operation,48 cases were followed up, follow up time was 6 - 18 months, average 12.5 months, including 25 cases of PF - LCP group, PFNA group of 23 cases. The amount of intranperative bleeding,operationtime,postoperative drainage of PFNA group were lower than those of PF - LCP group（ P 〈0.01） ,while the two group in the time of fracture healing,joint function rehabilitation（ Harris score） was no statistically significant differences（ P 〉0. 05 ）. Conclusion： The locking plate of proximal femoral intertrochanteric fractures or proximal femoral nail antirotation all can obtain good therapeutic effect, clinical should select the appropriate methods of internal fixation according to different types of fractures.