两种手术方式治疗老年股骨转子间骨折患者的临床分析

目的探讨两种手术治疗老年股骨转子间骨折的临床疗效。方法将66例老年股骨转子间骨折患者按骨折类型均匀分为两组,分别采用骨近端髓内钉(PFN)固定及股骨近端解剖锁定钢板固定两种手术术式进行治疗,比较两组手术时间、出血量、骨折复位情况、患者下床时间、骨折愈合情况及伤髋功能。结果两种手术方式在手术时间、出血量、骨折愈合及伤髋功能方面比较,差异无统计学意义(P>0.05);在骨折复位方面,使用股骨近端解剖钢板固定,骨折复位更理想,但需要特别强调大小转子重建及固定的重要性;在早期下床方面,PFN内固定治疗组下床时间更早,差异有统计学意义(P<0.05)。结论两种术式对老年股骨转子间骨折均有较好的临床治疗效果。

Clinical analysis of two kinds of surgical treatments of senile femoral intertrochanteric fractures

Objective To explore the clinical efficacy of two surgical treatments in senile femoral intertrochanteric fractures. Methods 66 old patients with intertrochanteric fractures were randomly divided into two groups according to the types of fractures, two groups were treated by PFN fixation and fixation of the proximal femoral anatomy locking plate respectively. The two kinds of surgical treatments were compared in the following aspects：operation time, blood loss, reduction of fractures, ambulation time, fracture healing and the function of the injured hip. Results Between the two surgical methods, there was no significant difference in operation time, blood loss, fracture healing and the function of the injured hip（P〉0.05）. In fracture reduction, the fixation of the proximal femoral anatomy locking plate was better but needs to be emphasized in the importance of the resetting of the big and small trochanters and in fixation. In early ambulation, patients with PFN fixation could be significantly earlier in ambulation （P〈 0.05）. Conclusion The two kinds of surgical treatments are both effective for senile intertrochanteric fractures.