锁定加压钢板与股骨近端防旋髓内钉治疗股骨转子间骨折疗效分析

目的：探讨锁定加压板与股骨近端防旋髓内钉治疗老年股骨转子间骨折的临床疗效并比较两种术式的优劣。方法选取禹城市人民医院2009年05月至2012年03月老年股骨转子间骨折者121例，按纳入排除标准选择其中68例，分别应用LCP及PFNA手术方式进行治疗，对两组手术操作时间、术中出血量、术后完全负重时间、骨折愈合时间、髋关节功能评分、术后并发症等方面进行分析。结果 LCP内固定组：手术时间69.35±13.47 min（50～125 min），出血量182.37±21.42 ml（120～350 ml），完全负重时间9.78±1.32周，骨折愈合时间15.34±0.35周，Harris髋关节评分：优32例、良2例、可2例、优良率94.4％；PFNA内固定组：手术时间68.23±12.31 min（50～135 min）、出血量121.82±15.63 ml（80～200 ml），完全负重时间8.15±1.23周，骨折愈合时间15.42±0.45周，Harris髋关节评分：优29例、良2例、可1例、优良率96.8％。结论 PFNA和LCP是两种常用的老年股骨转子间骨折治疗方法，在术中出血量、术后完全负重时间方面 PFNA组明显优于LCP组，但具体术式选择应根据患者的具体情况和手术医师的技术经验而定。

Comparing of the clinical effect between PFNA and LCP on intertrochanteric fracture of elderly patients

Objective Compare the clinical effect between LCP and PFNA on intertrochanteric fracture of elderly patients . Methods 68 patients suffered from intertrochanteric fracture of elderly patients were observed .36 cases were undergo LCP(the locking compress plate)operation ,meanwhile 32 cases were undergo PFNA(proximal femoral nail antirotation)operation .Oper‐ating time ,operating bleeding volume ,time to full weight bearing ,recovery time and functional outcome(harris hip score)were observed .Results LCP:operating time 69.35 ± 13.47 min(50~125min) ,operating bleeding volume 182.37 ± 21.42 ml(120~350 ml) ,time to full weight bearing 9.78 ± 1.32 week ,recovery time 15.34 ± 0.35 week ,harris hip score:32cases got excellent result ,2case good ,2case poor ;PFNA :operating time 68.23 ± 12.31min(50~135 min) ,operating bleeding volume 121.86 ± 15.63ml(80 ~ 200 ml) ,time to full weight bearing 8.15 ± 1.23 week ,recovery time 15.42 ± 0.45 week ,harris hip score:29cases got excellent result ,2case good ,1case poor .Conclusion Compared to LCP operating method ,PFNA operating method has advantages in the operating length ,operating time ,operating bleeding volume and Harris hip score were decreased ,but which should be the first choose on the treatment of intertrochanteric fracture of elderly patients must be choice according to the specific situation and the ability of physician .