摘要
目的探讨亚洲型股骨近端防旋髓内钉(PFNA-Ⅱ)与新型股骨近端髓内钉(Inter Tan)治疗老年不稳定型股骨粗隆间骨折患者的临床疗效。方法选取2017年1月—2018年1月玉环市人民医院骨科收治的60例不稳定型股骨粗隆间骨折患者,按照随机数字表均分为2组。A组使用PFNA-Ⅱ内固定,B组应用Inter Tan内固定。观察比较2组患者手术时间、术中出血量、术中透视次数、术后引流量、术后开始下地时间、末次随访髋关节Harris功能评分、骨折愈合时间、术后3个月大腿疼痛程度、股骨颈短缩及并发症等。结果 A组在手术时间、术中出血量、术中透视次数、术后引流量方面优于B组;B组在术后开始下地时间、骨折愈合时间、术后并发症、术后3个月大腿疼痛程度、股骨颈短缩及并发症方面优于A组,差异有统计学意义(P<0.05);2组患者末次随访髋关节功能比较差异无统计学意义。结论 PFNA-Ⅱ和Inter Tan均为微创髓内固定,在老年不稳定性股骨粗隆间骨折患者各具有优势。PFNA-Ⅱ手术时间短,操作简单、创伤小,术中出血少;Inter Tan固定更牢靠、加压效果好、具有良好的生物力学优势及稳定性,早期并发症少,骨折愈合时间短,有利于快速康复。
Objective To explore the clinical effect of Asian type PFNA-Ⅱand new Inter Tan in the treatment of elderly unstable intertrochanteric fractures.Methods Sixty patients with unstable intertrochanteric fractures admitted in the Orthopaedic Department of Yuhuan People’s Hospital from January 2017 to January 2018 were randomly divided into two groups.Group A were used PFNA-Ⅱinternal fixation,while group B were used Inter Tan internal fixation.The operation time,intraoperative blood loss,intraoperative fluoroscopy time,post-operative drainage volume,the time of postoperative onset,the last follow-up of hip joint function Harris score,fracture healing time,after three months thigh pain,femoral neck shortening,complications were compared between two groups.Results The operation time,intraoperative blood loss,intraoperative fluoroscopy time,postoperative drainage volume in the group A were better than those in the group B,while the time of postoperative onset,fracture healing time,complications,after three months thigh pain,femoral neck shortening,complications in the group B were better than those in the group A(P<0.05).There were no significant differences in the last follow-up of hip joint function Harris score between two groups.Conclusion PFNA-Ⅱand Inter Tan are minimally invasive intramedullary fixation,each has its advantages in the elderly patients with unstable intertrochanteric fracture.The PFNA-Ⅱhas the advantages of short operation time,simple operation,less trauma and less bleeding,while Inter Tan is more reliable,with good compression effect,good biomechanical advantage and stability,less early complications and short fracture healing time,which is conducive to rapid recovery.
作者
曹建国
邓敦
陈宇
陈文辉
龙治强
金文锦
CAO Jian-guo;DENG Dun;CHEN Yu;CHEN Wen-hui;LONG Zhi-qiang;JIN Wen-jin(Department of Orthopedic,People’s Hospital of Yuhuan City,Yuhuan,Zhejiang 317600,China;不详)
出处
《中华全科医学》
2020年第9期1493-1495,1598,共4页
Chinese Journal of General Practice
基金
浙江省中医药科研项目(2019ZB144)。
