人工股骨头置换和股骨近端防旋髓内钉治疗老年股骨转子间骨折疗效分析.docVIP

人工股骨头置换和股骨近端防旋髓内钉治疗老年股骨转子间骨折的疗效分析 　　doi：10.3969/j.issn.1007-614x.2014.14.23 　　摘 要 目的：观察人工股骨头置换和股骨近端防旋髓内钉（PFNA）在治疗老年股骨转子间骨折的疗效并进行分析比较。方法：2009年1月-2012年12月收治老年股骨转子间骨折患者52例，采用人工股骨头置换（A组）24例，PFNA内固定（B组）28例。平均随访时间16个月。比较两组患者在手术时间、手术失血量、术后不良事件、Harris评分的差异。结果：B组手术时间、手术失血量明显低于A组，差异有统计学意义（P0.05），术后6个月、12个月差异有统计学意义（P0.05）。结论：PFNA是治疗老年股骨转子间骨折的有效方法。手术时间短，失血量少，术后不良事件少，功能恢复良好，疗效肯定，是理想的治疗老年股骨转子间骨折的方法。 　　关键词 PFNA内固定 股骨头置换 股骨转子间骨折 　　Curative effect analysis of artificial femoral head replacement and PFNA for treatment of femoral intertrochanteric fractures in the elderly patients 　　Ma Xianghai1，Shi Peiqin2，Shen Wenrui2，Che Guiyi2，Xing Dehua2，Sun Kang1 　　Joint surgery of Huangdao Hospital district of The Affiliated Hospital of Medical College of Qiingdao University of Qingdao City in Shandong Province，2660001 　　The first Department of orthopedics of Juxian Peoples Hospital of Shandong Province，2765002 　　Abstract Objective：To explore the curative effect of artificial femoral head replacement and PFNA for treatment of femoral intertrochanteric fractures in the elderly patients and to make a comparison and analysis.Methods：We selected 52 elderly patients of femoral intertrochanteric fractures from January 2009 to December 2012.（A group）24 cases were treated by artificial femoral head replacement，while （B group）28 cases were treated with PFNA internal fixation.The mean follow-up time was 16 months.The differences of operation time，blood loss in the operation，postoperative adverse events，Harris score between the two groups were compared.Results：In the B group，operation time and blood loss in the operation were significantly lower than that in A group，and the difference was statistically significant（P0.05），and the difference was statistically significant at 6 months and 12 months after operation（P0.05）.Conclusion：PFNA is an effective method in the treatment of femoral intertrochanteric fractures in the elderly patients.Operation time is short，blood loss is less，postoperative advers