摘要
目的比较InterTan髓内钉、股骨近端防旋髓内钉(PFNA)、Gamma 3型髓内钉内固定治疗老年不稳定股骨粗隆间骨折的临床疗效。方法纳入自2012-01—2017-01新疆维吾尔自治区人民医院行髓内固定手术治疗的152例老年不稳定股骨粗隆间骨折,48例采用InterTan内固定治疗(InterTan组),51例采用PFNA内固定治疗(PFNA组),53例采用Gamma 3型髓内钉内固定治疗(Gamma 3组)。比较3组手术时间、术中出血量、住院时间、术后开始负重时间、术后并发症发生率,以及术后3、12个月髋关节功能Harris评分。结果 PFNA组1例术后1个月出现螺钉松动、内固定失效,行翻修手术,患者于翻修术后出现切口感染,最终死于脓毒血症、多器官功能衰竭。其余151例获得平均15.3(12～24)个月随访。3组手术时间、术中出血量、住院时间、术后开始负重时间、术后并发症发生率、术后髋关节功能Harris评分比较差异无统计学意义(P>0.05)。结论 InterTan、PFNA、Gamma 3型髓内钉内固定治疗老年不稳定股骨粗隆间骨折均可获得满意的临床疗效,患者术后髋关节功能恢复良好。
Objective To compare clinical outcomes of InterTan, proximal femoral nail antirotation （PFNA）, and Gamma 3 intramedullary nails in treatment of unstable femoral intertrochanteric fracture of elderly patients. Methods One hundred and fifty two elderly patients with unstable femoral intertrochanteric fracture treated in People＇s Hospital of Xinjiang Uygur autonomous region from January 2012 to January 2017 were retrospectively compared. Forty-eight patients were treated with InterTan （group InterTan）, 51 patients were treated with PFNA （group PFNA）, other 53 patients were treated with Gamma 3 （group Gamma 3）. Follow-up assessment included the operation time, amount of bleeding, hospitalization time, weight-bearing time after operation, postoperative complication rate and Harris score at 3 and 12 months after operation. Results Screw loosening and internal fixation failure occurred in 1 case one month after operation in group PFNA, underwent revision surgery, but incision infection occurred after revision surgery, and eventually died of sepsis and multiple organ failure. The average follow-up period was 15.3 （12-24） months in other 151 patients. There were no significant differences between the 3 groups in the operation time, amount of bleeding, hospitalization time, weight-bearing time after operation, postoperative complication rate and Harris score （P 〉0.05）. Conclusion InterTan, PFNA, and Gamma 3 intramedullary nails in treatment of unstable femoral intertrochanteric fractures of elderly can achieve satisfactory clinical results, and patients have good postoperative hip joint function recovery.
作者
李祖涛
周文正
缪晓刚
袁宏
孙俊刚
LI Zu-tao;ZHOU Wen-zheng;MIAO Xiao-gang;YUAN Hong;SUN Jun-gang(Department of Orthopedics,People＇s Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China)
出处
《中国骨与关节损伤杂志》
2018年第10期1017-1020,共4页
Chinese Journal of Bone and Joint Injury
基金
国家自然科学基金(81360276)
