摘要
[目的]回顾性分析INTERTAN髓内钉与PFNA-Ⅱ髓内钉治疗老年股骨粗隆间骨折临床疗效。[方法]自2011年1月∽2014年1月,回顾性分析本科收治的102例老年股骨粗隆间骨折患者,按照AO/OTA分型标准进行分类,A1型51例、A2型44例及A3型7例。其中55例采用Smith﹠Nephew公司INTERTAN髓内钉固定,47例采用Synthes公司PFNA-Ⅱ髓内钉固定。比较两组患者手术时间、术中出血量、切口长度、术后输血例数及输血量、骨折愈合时间、早期负重时间、内固定失效例数、大腿疼痛例数及末次随访髋关节功能Harris评分。[结果]所有患者获得6∽15个月随访,平均（9.50±3.02）个月。PFNA-Ⅱ组手术时间、术中出血量及术后输血量较INTERTAN组少（P〈0.05）,两组切口长度、骨折愈合时间、术后输血例数、内固定失败例数、早起负重时间、大腿疼痛程度和末次随访髋关节功能Harris评分差异均无统计学意义（P〉0.05）。[结论]PFNA-Ⅱ和INTERTAN均为髓内固定,各具优势。PFNA-Ⅱ操作简单,适用于内科合并症多,不易长时间手术者;INTERTAN理论上具有更高生物力学优势及稳定性,可减少患者术后股部疼痛。对于反粗隆间骨折,建议采用加长髓内钉固定,减少局部应力集中及再骨折风险。
[Objective]To retrospective analysis the clinical effect of INTERTAN intramedullary nail and PFNA- II intramedullary nail for elderly femoral intertrochanteric fracture. [Method]From January 2011 to January 2014,there were 102 cases of the elderly patients with femoral intertrochanteric fracture. The clinical data were retrospectively analyzed. According to the AO / OTA classification standard,there were 51 cases of type A1,44 cases of type A2 and 7 cases of type A3. Among them,55 cases were treated with Smith ﹠ Nephew company INTERTAN intramedullary nail,while 47 cases were treated with Synthes PFNA- II intramedullary nail. Comparison of two groups was made on operation time,amount of bleeding during the operation,incision length,the number of cases of postoperative blood transfusion and volume of blood transfusion,healing time of fracture,early loading time,internal fixation failure cases,the number of cases of thigh pain and the last follow- up of hip joint function Harris score. [Result]All the patients were followed up for 6 to 15 months,with an average（9. 50 ± 3. 02） months. In PFNA- II group,the operation time,blood loss and postoperative blood transfusion amount was less than that of INTERTAN group（ P 0. 05）. In the two groups,no statistically significant differences（ P 0. 05） was found in length of incision,fracture healing time,postoperative blood transfusion cases,the number of cases of internal fixation failure,the number of cases of thigh pain and the last follow- up of hip joint function Harris score. [Conclusion]PFNA- II intramedullary nail and INTERTAN intramedullary nail are intramedullary fixation. Each method has its advantages. PFNA- Ⅱintramedullary nail has the advantages of simple operation. It is suitable for patients with more medical complications who can not tolerate long- time operation. INTERTAN intramedullary nail theoretically has higher biomechanical advantages and stability. It can reduce postoperative pain in the thigh. For anti- intertrochanteric fractures,we suggest using extended intramedullary nailing fixation,which can reduce the local stress concentration and the risk of re- fracture.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第10期897-901,共5页
Orthopedic Journal of China
