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股骨近端抗旋髓内钉内固定治疗老年股骨转子间骨折

Proximal femoral nail antirotation internal fixation in treating intertrochanteric femoral fractures of elderly subjects.

作者信息

Jia L, Zhang K, Wang Z G, Wang L, Yang S Y, Zheng Y P

机构信息

Orthopaedic Department, Qilu Hospital of Shandong University, Jinan, China.

Orthopedic Trauma, Binzhou Medical University Hospital, Binzhou, China.

出版信息

J Biol Regul Homeost Agents. 2017 Apr-Jun;31(2):329-334.

Abstract

This study compared the effect of dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) in the treatment of intertrochanteric femoral fractures of elderly subjects and evaluated the effect of PFNA internal fixation. Two hundred and sixteen elderly patients with intertrochanteric femoral fracture who received treatment in Binzhou Medical University Hospital, Shandong, China were selected. They were divided into a PFNA group which adopted PFNA for internal fixation and a DHS group which adopted DHS for internal fixation, 108 cases in each group. The physical condition of the patients in the two groups were recorded on admittance. The fracture was typed according to Evans-Jensen classification criteria. Patients were followed up after surgery to evaluate the postoperative recovery and Harris score of hip joint function. Except for the length of hospital stay, the length of incision, interoperative blood loss, volume of drainage and duration of operation of the PFNA group were all superior to those of the DHS group (P less than 0.05); the incidence of postoperative complications of the PFNA group was lower than that of the DHS group (P less than 0.05); the early Harris score of the treatment was superior to that of the DHS group, and there was no remarkable difference (P>0.05). PFNA has more advantages than DHS in treating intertrochanteric femoral fracture of the elderly; hence it is worth wide application in clinical use.

摘要

本研究比较了动力髋螺钉(DHS)与股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的效果,并评估了PFNA内固定的疗效。选取在中国山东省滨州医学院附属医院接受治疗的216例老年股骨转子间骨折患者。将其分为采用PFNA内固定的PFNA组和采用DHS内固定的DHS组,每组108例。记录两组患者入院时的身体状况。根据Evans-Jensen分类标准对骨折进行分型。术后对患者进行随访,以评估术后恢复情况及髋关节功能Harris评分。除住院时间外,PFNA组的切口长度、术中出血量、引流量及手术时间均优于DHS组(P<0.05);PFNA组术后并发症发生率低于DHS组(P<0.05);治疗早期的Harris评分优于DHS组,且差异无统计学意义(P>0.05)。PFNA在治疗老年股骨转子间骨折方面比DHS具有更多优势;因此,值得在临床中广泛应用。

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