Objective: To compare the clinical efficacy of artificial femoral head replacement and Proximal femoral nail antirotation (PFNA) in the treatment of unstable femoral intertrochanteric fractures in the elderly. Methods...Objective: To compare the clinical efficacy of artificial femoral head replacement and Proximal femoral nail antirotation (PFNA) in the treatment of unstable femoral intertrochanteric fractures in the elderly. Methods: This study retrospectively analyzed 60 elderly patients with unstable intertrochanteric fractures treated with PFNA and artificial femoral head replacement from 2015.06 to 2018.06, of which 34 were in the PFNA group (Group A) and 26 in the artificial femoral head replacement group (Group B). Statistical analysis of relevant surgical indicators such as surgical time, intraoperative blood loss, postoperative blood transfusion, postoperative time to landing, postoperative infection rate, hospital stay, number of secondary operations, postoperative VAS score, and postoperative Hip function score comparison. Results: All 60 patients were followed up for 1 - 24 months. Compared with the artificial femoral head replacement group, the operation time of PFNA group was shorter, the blood loss during operation was less, and the difference was statistically significant (P 0.05). Conclusion: The hip joint function and pain scores of the artificial femoral head replacement group in the early and follow-up periods are better than those of the PFNA group. The artificial femoral head replacement is more suitable for the treatment of elderly unstable intertrochanteric fractures.展开更多
[目的]比较股骨近端交锁髓内钉(intertan nail,IN)与股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)治疗老年不稳定型股骨转子间骨折(intertrochanteric femur fracture,IFF)的临床疗效。[方法] 2019月1月—2021年12月...[目的]比较股骨近端交锁髓内钉(intertan nail,IN)与股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)治疗老年不稳定型股骨转子间骨折(intertrochanteric femur fracture,IFF)的临床疗效。[方法] 2019月1月—2021年12月对114例老年不稳定型IFF患者行手术治疗,采用随机数字法将患者分为IN组58例,PFNA组56例。比较两组围术期指标、随访及影像结果。[结果] PFNA组手术时间[(45.3±8.0) min vs (49.6±7.9) min,P<0.05]、切口总长度[(4.5±1.2) cm vs (5.0±1.3) cm,P<0.05]、术中出血量[(81.7±10.3) ml vs (127.6±20.0) ml,P<0.05]、术中透视次数[(11.7±2.4)次vs (13.0±2.2)次,P<0.05]、扶拐下地时间[(6.5±1.2) d vs (7.6±1.4) d,P<0.05]、切口愈合时间[(12.0±2.3) d vs (13.4±3.1) d,P<0.05]、住院时间[(5.9±0.9) d vs (7.1±1.3) d,P<0.05]均显著优于IN组(P<0.05);两组临床骨折愈合时间的差异无统计学意义(P>0.05)。与术后6个月相比,术后12个月两组Harris评分、髋伸屈ROM、髋内-外旋ROM均显著增加(P<0.05);相应时间点,两组间Harris评分、髋伸屈ROM、髋内-外旋ROM的差异均无统计学意义(P>0.05)。影像方面,两组骨折复位质量、骨折愈合情况的差异无统计学意义(P>0.05)。相应时间点,两组间颈干角、前倾角的差异均无统计学意义(P>0.05),末次随访IN组TAD值[(23.4±2.5) mm vs (25.2±2.8) mm,P<0.05]显著小于PFNA组。[结论] IN与PFNA内固定术均可恢复老年不稳定型IFF患者髋关节功能,促进骨折愈合,但PFNA治疗术中出血量、透视次数少,手术时间、住院时间短,更适用于耐受力差的老年患者,而IN髓内钉治疗具有更佳的生物力学优势。展开更多
文摘Objective: To compare the clinical efficacy of artificial femoral head replacement and Proximal femoral nail antirotation (PFNA) in the treatment of unstable femoral intertrochanteric fractures in the elderly. Methods: This study retrospectively analyzed 60 elderly patients with unstable intertrochanteric fractures treated with PFNA and artificial femoral head replacement from 2015.06 to 2018.06, of which 34 were in the PFNA group (Group A) and 26 in the artificial femoral head replacement group (Group B). Statistical analysis of relevant surgical indicators such as surgical time, intraoperative blood loss, postoperative blood transfusion, postoperative time to landing, postoperative infection rate, hospital stay, number of secondary operations, postoperative VAS score, and postoperative Hip function score comparison. Results: All 60 patients were followed up for 1 - 24 months. Compared with the artificial femoral head replacement group, the operation time of PFNA group was shorter, the blood loss during operation was less, and the difference was statistically significant (P 0.05). Conclusion: The hip joint function and pain scores of the artificial femoral head replacement group in the early and follow-up periods are better than those of the PFNA group. The artificial femoral head replacement is more suitable for the treatment of elderly unstable intertrochanteric fractures.
文摘[目的]比较股骨近端交锁髓内钉(intertan nail,IN)与股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)治疗老年不稳定型股骨转子间骨折(intertrochanteric femur fracture,IFF)的临床疗效。[方法] 2019月1月—2021年12月对114例老年不稳定型IFF患者行手术治疗,采用随机数字法将患者分为IN组58例,PFNA组56例。比较两组围术期指标、随访及影像结果。[结果] PFNA组手术时间[(45.3±8.0) min vs (49.6±7.9) min,P<0.05]、切口总长度[(4.5±1.2) cm vs (5.0±1.3) cm,P<0.05]、术中出血量[(81.7±10.3) ml vs (127.6±20.0) ml,P<0.05]、术中透视次数[(11.7±2.4)次vs (13.0±2.2)次,P<0.05]、扶拐下地时间[(6.5±1.2) d vs (7.6±1.4) d,P<0.05]、切口愈合时间[(12.0±2.3) d vs (13.4±3.1) d,P<0.05]、住院时间[(5.9±0.9) d vs (7.1±1.3) d,P<0.05]均显著优于IN组(P<0.05);两组临床骨折愈合时间的差异无统计学意义(P>0.05)。与术后6个月相比,术后12个月两组Harris评分、髋伸屈ROM、髋内-外旋ROM均显著增加(P<0.05);相应时间点,两组间Harris评分、髋伸屈ROM、髋内-外旋ROM的差异均无统计学意义(P>0.05)。影像方面,两组骨折复位质量、骨折愈合情况的差异无统计学意义(P>0.05)。相应时间点,两组间颈干角、前倾角的差异均无统计学意义(P>0.05),末次随访IN组TAD值[(23.4±2.5) mm vs (25.2±2.8) mm,P<0.05]显著小于PFNA组。[结论] IN与PFNA内固定术均可恢复老年不稳定型IFF患者髋关节功能,促进骨折愈合,但PFNA治疗术中出血量、透视次数少,手术时间、住院时间短,更适用于耐受力差的老年患者,而IN髓内钉治疗具有更佳的生物力学优势。
