PFNA与股骨近端锁定钢板治疗不稳定股骨转子骨折疗效分析.docVIP

PFNA与股骨近端锁定钢板治疗不稳定股骨转子骨折疗效分析 　　【摘要】 目的：探讨PFNA与股骨近端锁定钢板治疗不稳定股骨转子骨折的临床疗效。方法：将本院于2012年1月-2013年6月收治的106例不稳定股骨转子骨折患者随机分为PFNA组及股骨近端锁定钢板（LPFP）组，每组53例，PFNA组采用新型股骨近端内固定系统治疗，LPFP组采用股骨近端锁定钢板固定，比较两组患者的手术相关指标，术后3个月、12个月Harris评分情况及术后并发症情况。结果：PFNA组患者平均手术时间、术后卧床制动时间及骨折愈合时间均显著低于LPFP组（P0.001）；PFNA组术后3个月的疗效显著优于LPFP组，优良率显著高于LPFP组（P0.05）。PFNA组患者术后12个月随访的疗效及优良率均显著优于LPFP组（P0.05）；PFNA组患者术后未出现头颈部缩短、股骨头颈切割、髋内翻、内植物失败及股骨干骨折等严重骨科并发症，LPFP组患者中5例出现股骨近端锁定钢板断裂，引发髋内翻畸形，两组患者骨科并发症比较差异具有统计学意义（ 字2=5.248，P=0.022）。结论：PFNA治疗不稳定股骨转子骨折与LPFP手术比较，具有手术时间短、术后卧床制动时间短及术后恢复快、术后髋关节功能恢复好及术后并发症少等优势，值得应用。 　　【关键词】 PFNA； 股骨近端锁定钢板； 不稳定； 股骨转子骨折； 疗效 　　The Efficacy Analysis of Locking Proximal Femur Plates and PFNA Treated with Unstable Intertrochanteric Fractures/CHEN Ge-hai，ZHENG Jian-he，HUANG Ji-jia，et al.//Medical Innovation of China，2015，12（16）：004-007 　　【Abstract】 Objective：To explore the clinical efficacy of locking proximal femur plates and PFNA treated with unstable intertrochanteric fractures.Method：106 patients with unstable intertrochanteric fractures were randomly divided into the PFNA group and the locking proximal femur plates group（LPFP），each group contained 53 cases.The PFNA group were given the new system for the treatment of unstable intertrochanteric fractures and the LPFP group were treated with locking proximal femur plates.The surgery-related indicators，the Harris hip scores of 3months and 12 months after surgery and the complications were compared.Result：The mean operative time，postoperative bed braking time and fracture healing time of the PFNA group were significantly lower than that of the LPFP group（P0.001）.The efficacy and excellent rate in the PFNA group after 3 months and 12 months of followed-up were significantly higher than that in the LPFP group（P0.05）.Severe orthopedic complications such as the head and neck shortened，femoral neck cut，varus，plant failure and femoral shaft fractures didn’t appear in PFNA group.5 patients’ proximal femoral locking plate fractured and caused varus deformi