摘要
目的:探讨成人高位股骨转子下骨折两种髓内固定方法(重建钉与加长PFNA)的临床效果。方法:收治成人高位股骨转子下骨折患者42例,随机选取应用两种内固定方法治疗,其中22例应用重建钉治疗,20例应用加长PFNA治疗。结果:42例患者均得到随访,时间11～30个月,平均22.5个月,无死亡个案,重建钉组:手术时间120.2±14.5分钟,术中出血量361.5±108.7ml,下地行走时间7.3±0.9周,骨折愈合时间11.8±1.5周;加长PFNA组:手术时间90.4±18.1分钟,术中出血量292±102.6ml,下地行走时间7.2±0.8周,骨折愈合时间11.6±1.4周。在手术时间及术中出血量方面,两组差异有显著性意义,在下地行走时间及骨折愈合时间及髋关节功能方面没差异有显著性。结论:重建钉及加长PFNA均是治疗成人高位股骨转子下骨折的有效方法,但应用加长PFNA方法的病例,手术时间短,术中出血量更少。
Objective： To investigate adult high subtrochanteric femoral fractures two intramedullary fixation method （ reconstruction nail and extended PFNA ）clinical effect. Methods： a retrospective review of 2009 to 2011 in our department were adult high subtrochanteric femoral fractures patients, application of randomly selected two internal fixation method to treat 4-2 cases of cases,including 22 cases of application reconstruction nail treatment,20 cases of application extension PFNA treatment. Resuits： 42 patients were, time 11 - 30 months, an average of 22.5 months, no death case, reconstruction nail groups ： operation time was 120.2 ± 14. 5 min, intraoperativeamount of bleeding for 361.5 ± 108.7 ml, walk time for 7. 3 ± 0. 9 weeks, fracture healing time of 11.8 ± 1.5 weeks;Extended PFNA groups： operation time was 90. 4 ± 18.1 min,intraoperative amount of bleeding for 292 ± 102.6 ml,walk time for 7.2 ±0.8 weeks,fracture healing time of 11.6 ± 1.4 weeks. In the operation time and intraoperative amount of bleeding, two groups of significant difference, next along time and fracture healing time and hip function no significant difference. Conclusion ： reconstruction nail and extended PFNA are treatment subtrochanteric femoral fractures of adult high effective method, but application extension PFNA method of cases, surgery time is short, less intraoperative amount of bleeding.
关键词
重建钉
加长
PFNA
成人高位股骨转子下骨折
reconstruction nail
ExtendedPFNA
Adult high subtrochanteric femoralfractures
