摘要
目的探讨Inter Tan髓内钉及股骨近端防旋髓内钉（PFNA-Ⅱ）治疗老年股骨转子间骨折的安全性及临床疗效。方法选取2013年6月至2015年5月收治的高龄股骨转子间骨折患者90例,随机分为Inter Tan组和PFNA-Ⅱ组,每组各45例,其中Inter Tan组患者采用InterTan髓内钉治疗,PFNA-Ⅱ患者采用新型股骨近端带锁防螺旋髓内钉术治疗,对比分析两组患者的手术情况及康复情况。结果所有患者均随访3~8个月,PFNA-Ⅱ组患者的手术时间与InterTan组相比明显缩短,且术中出血量明显减少（P〈0.05）,而切口长度、骨折愈合时间与InterTan组相比无显著差异（P〉0.05）;InterTan组患者术后3个月和5个月的髋关节Harris评分明显优于PFNA-Ⅱ组（P〈0.05）,而术后8个月的Harris评分与PFNA-Ⅱ组相比无显著差异（P〉0.05）。PFNA-Ⅱ组2例术后出现下肢深静脉血栓,1例出现骨不连,而InterTan组无下肢深静脉血栓、骨不连、内固定断裂和股骨颈短缩等并发症发生。结论 InterTan与PFNA-Ⅱ髓内钉均为治疗股骨转子间骨折的有效手术方法,与InterTan髓内钉治疗法相比,PFNA-Ⅱ手术易操作,手术时间短,且术中出血少;InterTan髓内钉具有固定更牢靠、加压效果好、防旋抗切出和早期并发症少,有利于患者术后早期康复。
Objective To investigate the efficacy and safety of InterTan Intramedullary nail and proximal femoral nail anti - rotation - II（ PFNA - II）in the treatment of intertrochanteric fractures. Methods From June 2013 to May 2015,90 patients with intertrochanteric fracture treated in our hospital were selected and all patients were randomly divided into InterTan group and PFNA - II group,each contained 45 cases. Pa-tients in InterTan group were treated with InterTan fixation and the PFNA - II group used the new PFNA - II anti - helical proximal femoral nail in the treatment of intertrochanteric fractures. Compare the surgical conditions and rehabilitation situation between two groups. Results All patients were followed up for 3 - 8 months,the operative time in PFNA - II group was significantly shorter than that of the InterTan group,and the amount of blood loss was significantly reduced（ P ﹤ 0. 05）,while the length of the incision,the healing time showed no statistically differences between two groups（ P ﹥ 0. 05）. The Harris scores of 3 months and 5 months after operation in InterTan group were significantly better than those of the PFNA - II group（ P ﹤ 0. 05）,but there was no significant difference of Harris scores between two groups 8 months after operation（ P ﹥ 0. 05） . 2 patients in PFNA - II group had deep vein thrombosis,1 case of nonunion,while no deep vein thrombosis,nonunion,fracture fixation and femoral neck shortening occurred in InterTan group. Conclusion Both PFNA - Ⅱand InterTan System are effective surgical in the treatment of intertrochanteric fractures,compared with InterTan System. The method of PFNA - Ⅱis easier and the operation time is shorter. It had less blood loss in operation;and InterTan System has more reliable fixation,better compression and antirotation effect and less occurences of early complica-tions,which is conducive to the early rehabilitation of patients after surgery.
出处
《临床和实验医学杂志》
2016年第15期1531-1534,共4页
Journal of Clinical and Experimental Medicine
