加长PFNA治疗粗隆下骨折30例疗效分析

目的分析加长防旋股骨近端髓内钉（加长PFNA）治疗股骨粗隆下骨折的临床效果。方法选取2009年8月—2010年8月该院骨科收治的股骨粗隆下骨折患者60例,将采用加长PFNA治疗的30例患者作为加长PFNA组,采用动力髋螺钉（DHS）治疗的30例患者作为DHS组,比较两组治疗效果。结果加长PFNA组患者手术时间,术中出血量均少于DHS组,且差异具有统计学意义（P〈0.05）。DHS组总有效率70.0%,加长PFNA组总有效率90.0%,加长PFNA组总有效率高于DHS组,且差异具有统计学意义（χ2=3.892,P=0.049〈0.05）。两组患者股骨头坏死,切口疼痛及感染等并发症发生率差异无统计学意义（P〉0.05）。结论加长防旋股骨近端髓内钉治疗股骨粗隆下骨折临床效果满意,建议在临床治疗中推广应用。

Clinical Effective Analysis of 30 Patients with Subtrochanteric Fractures Treated by Extended Proximal Femoral Nail Anti-rotation

Objective To analyze the clinical effect of extended proximal femoral nail anti-rotation （extended PFNA） on patients with subtrochanteric fractures. Methods 60 patients with subtrochanteric fractures admitted in the department of orthopedics of our hospital from August 2009 to August 2010 were selected. Of them, 30 patients treated by extended PFNA were set as the extended PFNA group, and 30 patients treated by dynamic hip screw （DHS） were set as the DHS group. And the clinical effects were com- pared between the two groups. Results The operative time and intraoperative blood loss of the extended PFNA group were less than those of the DHS group with statistically significant difference （P〈0.05）. The total efficiency rate of the extended PFNA group was 90.0%, higher than 70.0% of the DHS group, the difference was statistically significant （χ2=3.892, P=-0.049〈0.05）. The differ- ence in the incidence of osteonecrosis of the femeral head, incision pain and infection and other complications between the two groups was not statistically significant（P〉O.05）. Conclusion Extended proximal femoral nail anti-rotation has satisfied effect in the treatment of subtrochanteric fractures, and is recommended to be used and popularized in clinical practice.