股骨近端解剖锁定钢板与股骨近端防旋髓内钉治疗不稳定型股骨转子间骨折的比较研究

目的:探讨股骨近端解剖锁定钢板(PFLP)与股骨近端防旋髓内钉(PFNA)治疗不稳定型股骨转子间骨折的疗效。方法:选取我院2013年6月至2016年3月期间收治的160例不稳定型股骨转子间骨折患者为研究对象,采用乱数表法分为观察组、对照组,各80例。对照组采用PFLP治疗,观察组患者采用PFNA治疗。统计分析两组的手术及术后相关指标以及术后3个月、6个月、12个月的髋关节功能Harris评分,比较两组的术后并发症。结果:观察组患者的手术时间、切口长度短于对照组,术中出血量、术中输血量、术后引流量均少于对照组(P0.05);观察组患者术后患侧负重时间、住院时间均短于对照组(P0.05);观察组患者骨折愈合时间短于对照组,但无统计学差异(P0.05);术后3个月、6个月,观察组患者髋关节功能Harris评分均高于对照组(P0.05);术后12个月,观察组患者髋关节功能Harris评分高于对照组,但无统计学差异(P0.05);两组患者并发症发生率比较无统计学差异(P0.05)。结论:PFNA与PFLP均能够有效治疗不稳定型股骨转子间骨折,但PFNA治疗方式在近期疗效中的作用优于PFLP,且患者髋关节功能恢复更快。

Comparative Study of Proximal Femoral Anatomic Locking Plate and Proximal Femoral Nail Anti-Rotation in the Treatment of Unstable Intertrochanteric Fractures

ABSTRACT Objective: To investigate the effect of proximal femoral anatomic locking plate (PFLP) and proximal femoral nail anti- rotation (PFNA) in the treatment of unstable intertrochanteric fractures. Methods: 160 unstable intertrochanteric fracture patients who were treated in our hospital from June 2013 to March 2016 were collected as the research objects, the patients were divided into observa- tion group and control group by random number table method, each group contained 80 cases. The control group was treated with PFLP, and the observation group were treated with PFNA. The operation of the two groups and postoperative related indexes, and the Harris score of hip function at 3 months, 6 months and 12 months after operation was evaluatedwere analyzed statistically, the postoperative complications of the two groups were compared. Results: The operation time, incision length of patients in observation group were short than those of the control group, and the intraoperative blood loss, intraoperative blood transfusion volume and postoperative drainage vol- ume were less than those of the control group(P<0.05). The weight bearing time after operation and length of hospital stay in the obser- vation group were shorter than those in the control group(P<0.05). The fracture healing time of the observation group was shorter than that of the control group, but there was no statistical difference(P>0.05). The Harris scores of hip function in the observation group were higher than those in the control group at 3 months and 6 months after operation(P<0.05). The Harris score of hip function in the observa- tion group was higher than that in the control group at 12 months after operation, but there was no statistical difference(P>0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05). Conclusion: Both PFNA and PFLP can effectively treat unstable intertrochanteric fractures, but PFNA treatment is superior to PFLP in the short-term effect, and the hip function of the patients is also restored more quickly.