| PFNA和ALP治疗老年股骨转子间骨折的疗效对比研究 |
| 投稿时间：2016-11-12 修订日期：2016-12-08 点此下载全文 |
| 引用本文：郭义超,彭阿钦,周晓哲,刘勇.PFNA和ALP治疗老年股骨转子间骨折的疗效对比研究[J].医学研究杂志,2017,46(8):188-190 |
| DOI：
10.11969/j.issn.1673-548X.2017.08.047 |
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| 中文摘要:目的 比较股骨近端防旋转髓内钉（proximal femoral nail antirotation PFNA）和股骨近端解剖型锁定钢板（anatomic proximal femoral locking plate ALP）治疗老年股骨转子间骨折的疗效。方法 收集2011年1月~2014年1月于笔者医院行PFNA和ALP手术并得到完整随访的病例42例，PFNA组22例，ALP组20例，按AO/OTA分型。记录两组患者手术时间、手术切口长度、术中失血量、术后患肢负重时间、术后并发症、骨折愈合时间和术后3个月Harris髋关节功能评分，进行统计学处理。结果 两组病例年龄、性别、骨折类型及Singh指数比较，差异无统计学意义（P>0.05），有可比性。两组患者手术时间、切口长度、术中出血量、患肢负重时间、骨折愈合时间比较，差异均有统计学意义（P<0.05）。术后3个月两组患者Harris评分优良率比较，差异有统计学意义（P<0.05）。PFNA和ALP组术后并发症髋内翻和内固定松动的发生率比较，差异有统计学意义（P<0.05），其他术后并发症发生率比较，差异无统计学意义（P>0.05），两组术后并发症总发生率比较，差异有统计学意义（P<0.05）。结论 PFNA与ALP比较具有创伤小、手术时间短、术中出血少，且操作简单、固定可靠，能使患者早期下地负重及功能锻炼；PFNA治疗股骨转子间骨折疗效好于ALP，便于基层开展。 |
| 中文关键词:髓内钉 锁定钢板 股骨 转子间 骨折 |
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| Comparison of Efficacy of Proximal Femoral Nail Antirotation and Anatomic Proximal Femoral Locking Plate in the Treatment of Intertrochanteric Fractures |
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| Abstract:Objective To compare the clinical results of intertrochanteric fractures using proximal femoral nail antirotation (PFNA) and anatomic proximal femoral locking plate(ALP). Methods A review study was conducted in 42 patients who were treated by means of PFNA and ALP and followed up from January 2011 to January 2014. According to the AO/OTA classification,22 cases were treated with PFNA and 20 cases with ALP. We evaluated their operation time, incision length, intra-operative bleeding, post-operative weight bearing-time, post-operative complications, healing time of fracture and the ADL scores 3 months after the operation. Results There were significant differences between the two groups in comparison of sex, age, fracture type,and Singh Index(P>0.05). Big differerces between the two groups can be seen in comparison of their operation time, incision length, intra-operative bleeding, weight bearing-time, healing time of fracture (P<0.05). 3 months after the operations, we can see the differences between the 2 groups in comparison of Harris scores. The comparison of post-operative complications:there are differences between the PFNA and ALP groups in hip varus and internal fixation, still in the general complications(P<0.05), but no differences in comparison of the related complications. Conclusion In comparison, PFNA has the advantages such as shorter incision length,shorter operative time, less blood loss, more simple operation,more reliable fixation,and earlier weight beating. PFNA is superior to ALP in treating intertrochanteric fractures, which can be applied conveniently to the grassroots. |
| keywords:Intramedullary nailing Locking plate Femur Intertrochanteric Fracture |
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