| 王攀.股骨距重建结合锁定钢板固定和股骨近端抗旋髓内钉治疗老年转子间骨折 46例分析[J].安徽医药,2021,25(4):693-696. |
| 股骨距重建结合锁定钢板固定和股骨近端抗旋髓内钉治疗老年转子间骨折 46例分析 |
| Intertrochanteric fractures in the elderly treated with femoral calcar reconstruction com? bined with locking plate fixation and proximal femoral nail antirotation: an analysis of 46 cas? es |
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| DOI：10.3969/j.issn.1009-6469.2021.04.014 |
| 中文关键词: 股骨骨折 骨折固定术，髓内 骨钉 转子间骨折 股骨近端抗旋髓内钉 老年人 |
| 英文关键词: Femoral fractures Fracture fixation, intramedullary Bone nails Intertrochanteric fracture Proximal femoral |
| 基金项目:国家自然科学基金面上项目(81471141) |
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| 中文摘要: |
| 目的探讨老年股骨转子间不稳定骨折病人股骨距重建结合锁定钢板固定与股骨近端抗旋髓内钉(PFNA)治疗的临床效果。方法选择 2017年 1月至 2018年 2月在宜宾市第二人民医院就诊的老年股骨转子间不稳定骨折病人作为研究对象，共纳入病人 92例，采用随机数字表法将病人分为钢板组和 PFNA组各 46例。钢板组给予股骨距重建结合锁定钢板固定， PFNA组给予 PFNA治疗。观察两组切口长度、手术时间、术中出血量、术后部分负重时间、术后并发症发生率和临床效果。结果 PFNA组手术时间［(60.48±8.62)min比(86.32±9.73)min］、手术切口［(6.73±1.71)cm比(13.27±2.38)cm］、术中出血量［(65.83±11.49)mL比(182.48±29.26)mL］均低于钢板组，均差异有统计学意义(P<0.05)，两组部分负重时间相比较差异无统计学意义(P>0.05)。PFNA组术后并发症发生率与钢板组差异无统计学意义(P>0.05)。两组临床疗效相比较差异无统计学意义(P>0.05)。结论股骨距重建和 PFNA治疗老年股骨转子间不稳定骨折均可获得良好效果，两者相比较， PFNA具有更好的微创效果，而股骨距重建结合锁定钢板固定可通过股骨距重建可减少头切割的发生，两者各有优缺点，临床可根据病人身体情况合理选择。 |
| 英文摘要: |
| Objective To investigate the clinical effect of femoral calcar reconstruction combined with locking plate fixation andproximal femoral nail antirotation (PFNA) in elderly patients with unstable intertrochanteric fracture.Methods Ninety-two elderly patients with unstable intertrochanteric fracture of femur treated in Yibin Second People's Hospital from January 2017 to February 2018were enrolled in this study and assigned into plate group and PFNA group by random number table, with 46 cases in each group. Plategroup was treated with femoral calcar reconstruction combined with locking plate fixation, and PFNA group was treated with PFNA.The incision length, operation time, intraoperative blood loss, partial weight-bearing time, incidence of complications and clinical effects were observed in the two groups.Results The operation time [(60.48±8.62) min vs (86.32±9.73) min], incision length [(6.73± 1.71) cm vs (13.27±2.38) cm] and intraoperative blood loss [(65.83±11.49) mL vs (182.48±29.26)mL] in PFNA group were lower than those in plate group, and the difference was statistically significant (P<0.05). There was no significant difference in partial weight-bearing time between the two groups (P>0.05). The incidence of postoperative complications in PFNA group was not statistically differentfrom that in plate group, and there was no significant difference in clinical efficacy between the two groups (P>0.05).Conclusion Femoral calcar reconstruction in combination with PFNA can achieve a good effect in treating elderly patients with unstable intertrochanteric fracture. Compared with plate, PFNA has better minimally invasive effect, while reconstruction of femoral calcar combinedwith locking plate fixation can reduce the incidence of head incision through reconstruction of femoral calcar. Both of them have theiradvantages and disadvantages, and can be selected according to the patient's physical condition. |
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