锁定加压钢板与股骨近端防旋髓内钉治疗不稳定股骨转子间骨折的临床疗效分析

目的 对比分析锁定加压钢板（LCP）与股骨近端防旋髓内钉（PFNA）治疗不稳定股骨转子间骨折的临床疗效.方法 回顾性收集采用LCP或PFNA治疗的60例不稳定股骨转子间骨折患者的临床资料,其中采用LCP治疗28例（LCP组）,PFNA治疗32例（PFNA组）.分析比较两组患者手术切口长度、手术时间、术中出血量、术后引流量、下床负重时间、骨折愈合时间、术后髋关节功能等指标情况.结果 所有患者术后均获得3～18（7.8±1.9）个月的随访.PFNA组患者手术切口长度[（8.3±1.8）cm]、手术时间[（46.4±14.3） min]、下床负重时间[（9.3±3.2）周]明显短于LCP组[（19.2±2.5）cm、（93.7±21.4） min、（16.1±2.4）周],术中出血量[（110.3±40.8）ml]、术后引流量[（52.8±24.7） ml]明显少于LCP组[（397.5±160.5）、（186.9±77.9） ml],差异均有统计学意义（P＜0.05）.两组骨折愈合时间、术后髋关节功能优良率及Harris髋关节功能评分比较差异无统计学意义（P＞0.05）.结论 两种内固定方法治疗不稳定股骨转子间骨折均能获得良好治疗效果,但PFNA固定方式在术中出血量、手术时间等方面优于LCP固定方式,在不稳定股骨转子间骨折的治疗上具有一定的优势.

Clinical effects analysis of lock compress plate and proximal femoral nail anti-rotation in the treatment of unstable intertrochanteric fracture

Objective To compare the clinical effect between lock compress plate （LCP） and proximal femoral nail anti-rotation （PFNA） in the treatment of unstable intertrochanteric fractures.Methods The data of 60 patients with unstable intertrochanteric fractures were retrospectively analyzed,including 28 patients were treated with LCP （LCP group） and 32 patients were treated with PFNA （PFNA group）.The incision length,operation time,volume of blood loss,postoperative drainage volume,full weight bearing time,fracture healing time,postoperative hip joint function were compared between the 2 groups.Results All the patients＆#39; postoperative follow-up period was 3-18 （7.8 ± 1.9） months.The incision length,operation time,full weight bearing time in PFNA group were significantly shorter than those in LCP group [（8.3 ± 1.8） cm vs.（19.2 ± 2.5）cm,（46.4 ± 14.3） min vs.（93.7 ± 21.4） min,（9.3 ± 3.2） weeks vs.（16.1 ± 2.4） weeks],the volume of blood loss and postoperative drainage in PFNA group were significantly lower than those in LCP group [（110.3 ± 40.8） ml vs.（397.5±160.5） ml and （52.8 ± 24.7） ml vs.（186.9 ± 77.9） ml],there were statistical differences （P〈 0.05）.There were no statistical differences in fracture healing time,excellent and good rate of postoperative hip joint function and Harris hip joint function score between the 2 groups （P 〉0.05）.Conclusion Two internal fixation methods all can obtain good therapeutic effect,but PFNA is better than LCP in operation time,volume of blood loss and so on,and has advantages in the treatment of unstable intertrochanteric fracture.