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股骨近端防旋髓内钉与半髋关节置换术治疗股骨转子间骨折的对比研究。

Proximal femoral nail antirotation versus hemiarthroplasty: a study for the treatment of intertrochanteric fractures.

机构信息

Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, PR China.

出版信息

Injury. 2012 Jun;43(6):876-81. doi: 10.1016/j.injury.2011.11.008. Epub 2011 Dec 12.

Abstract

Intertrochanteric fractures in elderly patients are always associated with poor prognosis in the functional outcome as a result of the complications and mortality. A retrospective study was performed in our institution, 303 consecutive patients were followed up with mean age of 81.7 years. 147 were treated with PFNA, and 156 were underwent hemiarthroplasty. The average follow-up period was 39.9 months. The mortality at 1 month, 1 year, 3 years and the total was 6.6%, 18.6%, 27.6% and 30.3%, respectively. There were no significant differences between the groups in terms of demographic data. There were statistical significances in the operative statistics, especially the anaesthesia, operation lasting time, blood loss, blood transfusion and the drainage. There was no significant difference in Harris Hip Score between PFNA and hemiarthroplasty group, but the detail items were quite different. Significant difference was found in the excellent-to-fine rate (PFNA 90.2% and hemiarthroplasty 79.6%). Complications occurred in 34 patients, although incidences of complications were higher in hemiarthroplasty group (14.1% vs. PFNA 8.96%), no statistical difference was found. For elderly patients with intertrochanteric fractures, PFNA was superior to hemiarthroplasty according to the operative statistics, but there were no significant differences in functional outcome.

摘要

老年患者的股骨转子间骨折由于并发症和死亡率,其功能预后总是较差。我们对我院的一项回顾性研究进行了分析,共随访了 303 例连续患者,平均年龄为 81.7 岁。147 例行 PFNA 治疗,156 例行半髋关节置换术。平均随访时间为 39.9 个月。1 个月、1 年、3 年和总死亡率分别为 6.6%、18.6%、27.6%和 30.3%。两组在人口统计学数据方面无显著差异。手术统计学方面存在显著差异,尤其是麻醉、手术持续时间、出血量、输血和引流。PFNA 和半髋关节置换组的 Harris 髋关节评分无显著差异,但细节项目差异较大。优良率有显著差异(PFNA 为 90.2%,半髋关节置换术为 79.6%)。34 例患者发生并发症,尽管半髋关节置换组的并发症发生率较高(14.1%比 PFNA 组的 8.96%),但无统计学差异。对于老年股骨转子间骨折患者,根据手术统计学数据,PFNA 优于半髋关节置换术,但功能预后无显著差异。

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