摘要
目的比较可膨胀股骨近端髓内钉（Fixion PF）与股骨近端髓内钉（proximalfemoral nail，PFN）治疗老年股骨转子间骨折的临床效果。方法自2005年3月～2006年9月用PFN与Fixion PF治疗老年股骨转子间骨折48例，其中PFN治疗组27例，Fixion PF钉组21例。比较项目包括手术时间、出血量、术中X线照射时间、并发症以及功能恢复情况。结果所有病例均获得随访，平均随访9个月（3～22个月），骨折均愈合。Fixion PF组平均手术时间和手术切口长度小于PFN组（P〈0．05），术中X线透视次数、出血和引流量、离床和弃拐时间、骨愈合时间及Harris髋关节功能评分两组差昴元统计学意义。结论PFN与Fixion PF治疗老年股骨转子间骨折均有较好疗效，但Fixion PF钉固定后的应力分布均匀，远端不需锁定，近端加用股骨头栓钉能增加股骨头松质骨密度和固定强度，增加抗旋转能力，较适合于老年骨质疏松性股骨近端骨折的治疗，但对严重骨质疏松者慎用。
Objective To comparatively analyze the outcome of expandable intramedullary nailing system （Fixion PF nail） and proximal temoral nail （PFN） for the treatment of peritroehanteric fractures in aged patients. Methods From March 2005 to September 2006, 48 aged patients with peritrochanteric fraetures were treated with Fixion PF nail （=21） and PFN （11=17）. Comparison was made between the two groups with respect to time of operation, size of wound, frequency of X-ray exposure, blood loss and drainage, time needed to start walking without assistance, time of fracture healing, functional recovery and complications. Results All patients were followed up fbr 3-22 months with a mean of 9 months. All fractures achieved bone union. Splitting of the proximal femur occuned in one case in Fixion PF nail group, and varus malunion occurred in 2 cases and dynamic screw loosening in one case in PFN group. The results of data analysis suggest that operation time and skin incision of PFN group were longer than those of Fixion PF nail group （P〈0.05）. There were no significant differences between the two groups in the frequency of X-ray exposure, blood loss and drainage, the time to ambulate and walk without assistance, fracture healing time, Harris scoring of the hip function and the rate of complications. Conclusions Both Fixion PF nail and PFN are good for the treatment of peritrochanteric fractures in aged patients. Fixion PF nail seams to be more suitable for the treatment of osteoporotic fractures of the proximal femur in aged patients because of its homogenic load distribution, no need of reaming and interlocking as well as the high power of anti-rotation resulting from the head of the peg in the femoral head.
出处
《老年医学与保健》
CAS
2007年第6期354-356,365,共4页
Geriatrics & Health Care
关键词
股骨颈骨折
骨折固定术
髓内
骨钉
老年人
骨质疏松
Femoralneek fractures
Fracture fixation, intramedullary
Bone nails
Aged
Osteoporosis
