锁定钢板和PFNA治疗股骨粗隆间骨折的比较研究

摘要

Objective: To compare and observe the clinical efficacy of ALP and PFNA in treatment of intertrochanteric fractures, to provide clinical evidence for such patients. Methods:The clinical data of 122 cases patients with intertrochanteric fractures admitted to our department from January, 2012 to January, 2013 was analyzed retrospectively. 72 patients treated with PFNA were regarded as the study group and 50 patients with ALP as controls group. Two groups were compared with surgical incision, blood loss, operative time, healing time, hip functional recovery and postoperative complications. Results: The incision length, blood loss, operative time, postoperative weight-bearing activity time, fracture healing time, Harris score and complications of study group were significantly better than the control group (P<0.05), with statistical significance. Conclusion: The long-term efficacy of PFNA and ALP has no difference, but PFNA has smaller wound, less bleeding, sooner fracture healing time and weight-bearing activities and better early results.%目的：对比观察应用股骨近端解剖型锁定钢板(ALP)与股骨近端抗旋髓内钉(PFNA)治疗股骨粗隆间骨折的临床疗效，为此类患者的治疗提供临床依据。方法：回顾性分析122例股骨粗隆间骨折患者临床资料，根据治疗方式不同将其分为观察组72例和对照组50例；观察组采用PFNA治疗，对照组采用ALP治疗，比较两组患者手术切口、术中出血、手术时间、骨折愈合时间、髋关节功能恢复及术后并发症等情况。结果：观察组手术切口长度、术中平均出血量、平均手术时间、术后负重活动时间、骨折愈合时间及术后3个月Harris评分情况均显著优于对照组，差异有统计学意义(t=12.837，t=41.483，t=18.512，t=9.724，t=8.351，t=14.078；P＜0.05)。观察组并发症显著低于对照组，差异有统计学意义(x2=37.152，P＜0.05)。结论：PFNA及ALP长期疗效无差别，但PFNA创口更小、术中出血少、骨折愈合时间及负重活动时间更早，早期效果更好，值得推广应用。