近端膨胀髓内钉与抗旋髓内钉治疗老年股骨转子间骨折的临床疗效分析

目的:探究近端膨胀髓内钉与近端螺旋刀片抗旋髓内钉治疗老年股骨转子间骨折疗效及躁动发生率比较。方法:病例来源为2012年5月至2013年10月收入我院的老年股骨转子间骨折患者60例,采用随机数字表随机分为两组,膨胀钉组30例,采用近端膨胀髓内钉的手术方法,PFNA组30例,采用近端螺旋刀片抗旋髓内钉的手术方法。手术结束后,对两组患者进行X射线片、手术时间及出血量、髋关节功能的比较,同时对比躁动发生率。结果:X线检查结果显示两组患者经手术后骨折处均复位良好,无并发症及内固定物的脱落及松动,两组比较无显著差异(P0.05);与PFNA组相比,膨胀组患者的手术时间及出血量明显降低,差异具有统计学意义(P0.05);两组患者术后3个月、6个月的Harris评分显示,与PFNA组相比,膨胀钉组的优良率明显升高,髋关节优于PFNA组,差异具有统计学意义(P0.05);膨胀钉组患者躁动率为10.00%低于PFNA组患者躁动率为33.33%,具有统计学意义(P0.05)。结论:可膨胀髓内钉具有手术时间较短、出血量少,更利于骨折的愈合,且躁动发生率较低,对股骨转子间骨折的疗效优于较近端螺旋刀片抗旋髓内钉,对临床有指导意义,值得临床推广。

The Proximal End of Expandable Intramedullary Nail and Proximal Femoral Nail Anti Rotation Blade in the Comparison of Therapeutic Effects of Intertrochanteric Fractures of Femur

ABSTRACT Objective: To explore the proximal end of expandable intramedullary nail and proximal femoral nail anti rotation blade in the curative effect of femoral intertrochanteric fractures. Methods: 60 cases of cases come from 2012 May to 2013 October in our hospital in patients with income, the cases with femoral intertrochanteric fracture in clinical diagnosis, were randomly divided into two groups, expansion nail group 30 cases, use proximal expansion operation method of intramedullary nail, 30 cases in group PFNA, using surgery methods the proximal femoral nail anti rotation blade. After the surgery, X - ray, the two groups of patients with operation time and bleeding volume, the function of hip joint. Results: X-ray examination showed the two groups after operation after fracture reduction were well off and loose, without complications and internal fixation, compared the two groups had no significant difference (P>0.05) compared with PFNA group, the expansion operation time groups of patients and the amount of bleeding decreased obviously, the difference has statistical significance (P<0.05). The patients in two groups after 3 months, 6 months of Harris score revealed that, compared with PFNA group, the excellent and good rate of expansion nail group increased significantly, the hip joint is better than that of PFNA group, with statistically significant difference (P<0.05). Conclusion: The expandable intramedullary nail has the advantages of shorter operation time, less bleeding, more conducive to fracture healing, the intertrochanteric fracture better than the more proximal femoral nail anti rotation blade, a guide for clinical significance, is worth the clinical promotion.