股骨近端防旋髓内钉与联合加压交锁髓内钉治疗老年股骨转子间骨折的疗效比较研究

目的:研究对比股骨近端防旋髓内钉(PENA-Ⅱ)与联合加压交锁髓内钉(Inter Tan)治疗老年股骨转子间骨折的疗效。方法:选择2014年6月至2016年6月我院收治的老年股骨转子间骨折患者92例,按照随机数字表法分为PENA-Ⅱ组与Inter Tan组,每组各46例。两组患者分别接受PENA-Ⅱ治疗和Inter Tan治疗,术后进行为期12个月的随访。比较两组临床疗效、手术相关指标(手术时间、术中出血量、骨折愈合时间)、手术前后骨密度水平变化情况以及并发症发生情况。结果:PENA-Ⅱ组优良率为89.13%,略高于Inter Tan组的86.96%,但两组比较差异无统计学意义(P0.05)。PENA-Ⅱ组患者手术时间、术中出血量分别为(65.2±15.3)min、(57.2±29.3)m L,明显低于Inter Tan组患者的(84.3±13.8)min、(104.7±36.5)m L(P0.05),两组患者骨折愈合时间比较差异无统计学意义(P0.05)。术前、术后12周以及术后24周PENA-Ⅱ组患者的腰椎骨密度水平与Inter Tan组比较差异无统计学意义(P0.05)。两组切口感染、肺部感染、下肢深静脉血拴、近端股骨外侧皮质劈裂以及髋内翻发生率对比差异无统计学意义(P0.05)。结论:PENA-Ⅱ与Inter Tan治疗老年股骨转子间骨折的临床疗效相当,且两种手术方法对骨密度水平的影响及术后并发症发生率相似。但PENA-Ⅱ治疗具有手术时间短以及术中出血量少等优势,值得临床推广应用。

Comparative Study of Curative Effect on Proximal Femoral Anti Rotation Nail and Combine Compression Interlocking Intramedullary Nail in the Treatment of Intertrochanteric Fracture in the Elderly

ABSTRACT Objective: To compare and analyze the efficacy of proximal femoral anti rotation nail (PENA- II) and combine compression interlocking intramedullary nail (InterTan) in the treatment of intertrochanteric fracture in the elderly. Methods: 92 cases of elderly patients with intertrochanteric fracture who were treated in our hospital from June 2014 to June 2016 were selected, the patients were divided into PENA- II group and InterTan group according to the random number table method, 46 cases in each group. Two groups were received PENA- II treatment and InterTan treatment respectively, the patients were followed up for 12 months after the operation.The clinical efficacy, operative index (operation time, blood loss, fracture healing time), bone mineral density changes and complications were compared between the two groups. Results: The excellent and good rate of PENA- II group was 89.13%, slightly higher than 86.96% of InterTan group, but the difference between the two groups was not statistically significant (P>0.05). The operation time and intraoperative blood loss in PENA- II group were (65.2±15.3)min, (57.2±29.3)mL, significantly lower than (84.3±13.8)min, (104.7±36.5)mL in InterTan group (P<0.05), there was no significant difference in fracture healing time between the two groups (P>0.05). The level of lumbar bone density in PENA- II group before operation, 12 weeks after operation, and 24 weeks after operation were not significantly different from those in InterTan group (P>0.05). There was no significant difference between the two groups in incision infection, pulmonary infection, deep vein thrombosis, split of the lateral femoral cortex, and the incidence of coxa varus between the two groups (P>0.05). Conclusion: The clinical efficacy of PENA- II and InterTan in elderly patients with intertrochanteric fractures is equivalent, the effect of the two surgical methods on bone mineral density and the incidence of postoperative complications are similar.But PENA- II has the advantages of shorter operation time and less bleeding during operation, so it is worthy of clinical application.