Zhu Li-Jun, Li Xiao-Fei, Liu Chao, Lyu Cheng-Yu
Department of Joint Surgery, the Affiliated Hospital of Qiingdao University, Qingdao 266000, Shandong, China.
Department of Joint Surgery, the Affiliated Hospital of Qiingdao University, Qingdao 266000, Shandong, China;
Zhongguo Gu Shang. 2017 Jul 25;30(7):607-611. doi: 10.3969/j.issn.1003-0034.2017.07.005.
To evaluate the clinical results of locking proximal femur plate(LPFP), proximal femoral nail antirotation(PFNA) and bipolar hemiarthroplasty(BPH) in the treatment of femoral intertrochanteric fractures in elderly patients.
Retrospective analysis of the 86 elderly patients with femoral intertrochanteric fractures during June 2011 and August 2016 were enrolled in this study. The patients were divided into 3 groups: 26 cases in LPFP group included 10 males and 16 females with an average age of (72.54±4.78) years old, 5 cases of type II of Evans, 12 cases of type III and 9 cases of type IV; 39 cases in PFNA group included 17 males and 22 females with an average age of 74.41±5.65, 11 cases of type II, 18 cases of type III and 10 cases of type IV; 21 cases in BPH group included 9 males and 12 females with an average age of 76.23±6.97, 1 case of type II, 10 cases of type III and 10 cases of type IV. The data of three groups were collected for statistical analysis on the following aspects: operation time, intraoperative blood loss, the length of hospital stay, postoperative complications and Harris score of the hip joint function.
The wound healed well and no complication occurred. Eighty-four cases were follow-up, while 2 cases were lost, the follow-up rate was 97.6%. The patients were followed up for 22 to 41 months with an average of 26.3 months. For comparison of operation time and time of the hospital stay, BPH group was shorter than the LPFP and PFNA group(=19.782, 21.981, <0.05). For comparison of the intraoperative blood loss, the BPH group was less blood loss than the LPFP and PFNA group(=12.976, <0.05), while there was no significant means between the LPFP and PFNA group(=10.879, >0.05). For comparison of the postoperative complications, LPFP group was higher than BHP and PFNA group(=30.976, <0.05), while there was no significant means between LPFP and PFNA group(=9.902, >0.05). For comparison of the Harris score of the hip joint at 1 year after operation, BPH and PFNA group were both higher than LPFP group(=19.692, <0.05), while there was no significant means between BPH and PFNA group (=4.971, >0.05).
For elder patient with femoral intertrochanteric fracture, BPH could be the best optional for the shorter operation time and less complications. And the PFNA also could be optional choice for the patients while the LPFP was forbidden for the elder patients.
评估锁定股骨近端钢板（LPFP）、股骨近端抗旋髓内钉（PFNA）及双极半髋关节置换术（BPH）治疗老年股骨粗隆间骨折的临床效果。
回顾性分析2011年6月至2016年8月收治的86例老年股骨粗隆间骨折患者。将患者分为3组：LPFP组26例，男10例，女16例，平均年龄（72.54±4.78）岁，EvansⅡ型5例，Ⅲ型12例，Ⅳ型9例；PFNA组39例，男17例，女22例，平均年龄74.41±5.65岁，Ⅱ型11例，Ⅲ型18例，Ⅳ型10例；BPH组21例，男9例，女12例，平均年龄76.23±6.97岁，Ⅱ型1例，Ⅲ型10例，Ⅳ型10例。收集三组患者以下方面的数据进行统计分析：手术时间、术中出血量、住院时间、术后并发症及髋关节功能Harris评分。
伤口愈合良好，无并发症发生。84例获得随访，失访2例，随访率97.6%。患者随访22至41个月，平均26.3个月。手术时间及住院时间比较，BPH组短于LPFP组和PFNA组（=19.782，21.981，<0.05）。术中出血量比较，BPH组少于LPFP组和PFNA组（=12.976，<0.05），LPFP组与PFNA组比较差异无统计学意义（=10.879，>0.05）。术后并发症比较，LPFP组高于BPH组和PFNA组（=30.976，<0.05），LPFP组与PFNA组比较差异无统计学意义（=9.902，>0.05）。术后1年髋关节Harris评分比较，BPH组和PFNA组均高于LPFP组（=19.692，<0.05），BPH组与PFNA组比较差异无统计学意义（=4.971，>0.05）。
对于老年股骨粗隆间骨折患者，BPH手术时间短、并发症少，可作为首选；当老年患者禁忌使用LPFP时，PFNA也可作为选择。
