Görmeli Gökay, Korkmaz Mehmet Fatih, Görmeli Cemile Ayşe, Adanaş Cihan, Karataş Turgay, Şimşek Sezai Aykın
Department of Orthopedics and Traumatology, İnönü University Faculty of Medicine, Turgut Özal Medical Center, Malatya, Turkey.
Department of Radiology, İnönü University Faculty of Medicine, Turgut Özal Medical Center, Malatya, Turkey.
Ulus Travma Acil Cerrahi Derg. 2015 Dec;21(6):503-8. doi: 10.5505/tjtes.2015.96166.
The aim of this study was to compare the outcomes of intertrochanteric femur fractures treated with proximal femoral nail (PFN) and bipolar hemiarthroplasty (BPH) in elderly patients.
A total of one hundred and forty-three patients with intertrochanteric femur fractures treated surgically between January 2008 and January 2012 were included into the study. Patient demographics, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) classification, and the American Society of Anesthesiologists (ASA) classification system scores; type of surgical procedure (BPH or PFN), operative details, complications and follow-up scores (Harris Hip Score [HHS]; Mean Mobility Score [MMS]) were recorded.
The preoperative characteristics of the patients in both PFN and BPH groups were similar. BPH had higher operation times, blood loss in operation and mortality rates (p<0.005). Reoperation times were higher in PFN group (p<0.005). There were no differences with regard to the HHS and the reduction in MMS at the last follow-up with a 30.4 (10.9) months follow-up (p>0.05).
Although both PFN and BPH had satisfactory outcomes in surgically treated patients with intertrochanteric femur fractures, we recommend intertrochanteric femur fractures in the elderly tobe treated with PFN; which is an effective and appropriate treatment modality with less surgery related trauma and lower mortality rates.
本研究旨在比较老年患者股骨粗隆间骨折采用股骨近端髓内钉（PFN）和双极半髋关节置换术（BPH）治疗的效果。
纳入2008年1月至2012年1月期间接受手术治疗的143例股骨粗隆间骨折患者。记录患者的人口统计学资料、根据骨科学会/内固定研究学会（AO/ASIF）分类的骨折类型以及美国麻醉医师协会（ASA）分类系统评分；手术方式（BPH或PFN）、手术细节、并发症及随访评分（Harris髋关节评分[HHS]；平均活动度评分[MMS]）。
PFN组和BPH组患者的术前特征相似。BPH组的手术时间、术中失血量和死亡率更高（p<0.005）。PFN组的再次手术率更高（p<0.005）。末次随访（随访时间为30.4[10.9]个月）时，HHS及MMS降低情况无差异（p>0.05）。
虽然PFN和BPH治疗股骨粗隆间骨折手术患者的效果均令人满意，但我们建议老年股骨粗隆间骨折患者采用PFN治疗；这是一种有效且合适的治疗方式，手术相关创伤较小，死亡率较低。
