两种方法治疗不稳定性股骨转子间骨折的疗效比较

目的比较股骨近端防旋髓内钉(PFNA)与联合加压交锁髓内钉(InterTan)治疗不稳定性股骨转子间骨折的临床疗效。方法将124例不稳定性股骨转子间骨折患者按照内固定方法分为PFNA组(60例)和InterTan组(64例)。比较两组患者的手术时间、术中出血量、C臂机透视次数、住院时间、骨折愈合时间、术后并发症、术后髋关节功能评分。结果两组患者均获得随访,时间5~22个月。手术时间、术中出血量、C臂机透视次数PFNA组均短(少)于InterTan组(P<0.001)。住院时间、骨折愈合时间及术后髋关节功能评分两组比较差异均无统计学意义(P>0.05)。术后并发症InterTan组少于PFNA组(P<0.05)。结论PFNA手术创伤小,时间短,出血量更少,更适合一般状况差、手术耐受能力差的患者;InterTan稳定性好,术后并发症少,更利于不稳定骨折的固定及术前运动能力好的患者。

The effects comparison of two methods for treatment of unstable femoral intertrochanteric fracture

Objective To compare clinical efficacy of proximal femoral nail antirotation(PFNA)and intertrochanteric antegrade nailing(InterTan)in treatment of unstable intertrochanteric fractures of femur.Methods According to the different methods of internal fixation,124 patients with unstable intertrochanteric fracture were divided into PFNA group(60 cases)and InterTan group(64 cases).The operation time,intraoperative blood loss volume,the number of C-arm fluoroscopy,the time of hospitalization,the healing time of fracture,postoperative complications and Harris score between the two groups were compared.Results Both groups were followed up,time ranged from 5 months to 22 months.The PFNA group were superior to InterTan group in operation time,intraoperative bleeding volume and the number of C-arm fluoroscopy(P<0.001).There were no significant differences in time of hospitalization,fracture healing time and hip function score between the two groups(P>0.05).Postoperative complications in InterTan group was less than that in PFNA group(P<0.05).Conclusions PFNA has less trauma,short operation time and less blood loss volume,which is more suitable for patients with poor general conditions and poor surgical tolerance.InterTan has good stability and few postoperative complications,which is more conducive to unstable fracture fixation and better preoperative exercise ability.