PFNA与Gamma钉治疗老年股骨转子间骨折的疗效比较

目的观察股骨近端防旋加锁髓内钉(PFNA)与Gamma钉治疗老年股骨转子间骨折的临床疗效,探讨PFNA治疗老年股骨转子间骨折的应用价值。方法将100例老年股骨转子间骨折分为PFNA组(54例)和Gamma钉组(46例),分别采用PFNA和Gamma钉治疗,观察2组患者不同年龄段手术情况、术后恢复情况及手术并发症情况。结果 PFNA组各年龄段手术时间、术中出血量均明显低于Gamma钉组同年龄段患者(P0.05);2组患者骨折愈合时间比较无显著差异(P0.05);PFNA组75岁以上患者Harris评分明显高于Gamma钉组(P0.05);PFNA组术后并发症明显低于Gamma钉组(P0.05)。结论 PFNA治疗老年股骨转子间骨折具有固定牢靠、防旋能力好、手术创伤小、并发生少等优点,且适合各年龄段股骨转子间骨折。

Efficacy of PFNA and Gamma nail in treatment of intertrochanteric fractures in elderly

Objective to observe the efficacy and application value of PFNA and Gamma in the treatment of intertrochanteric fractures in elderly. Methods 100 patients with intertrochanteric fractures were divided into PFNA group and Gamma group, who received PFNA treatment and Gamma treatment respectively. And the operation status of patients at different ages, postoperative recovery, and complications were observed. Results The operation time, intraoperatve blood soss of PFNA group were lower than those of Gamma group （P 〈0. 05）. There was no significant difference in fracture healing time. The Harris score of the over 75s in PFNA group was higher than that in Gamma group （ P 〈 0. 05 ）, and the complications were less than Gamma group （ P 〈 0.05 ）. Conclusion PFNA was suitable for the patients at differ- ent ages with the advantages of more rigid fixation, good anti-rotation, fewer trauma and fewer complications.