股骨近端防旋髓内钉与经皮加压钢板微创治疗股骨粗隆间骨折的疗效对比

目的对比分析经皮加压钢板（percutaneous compression plating,PCCP）和股骨近端防旋髓内钉（proximal femur nail antirotation,PFNA）内固定治疗股骨粗隆间骨折的优缺点。方法按治疗方法将70例股骨粗隆间骨折患者分为PFNA组（38例,采用PFNA系统固定）和PCCP组（32例,采用PCCP系统固定）,比较2组手术时间、术中出血量、骨折愈合时间、下地负重时间、髋关节Harris评分和并发症的发生率。结果 2组骨折愈合时间和并发症发生率比较差异无统计学意义（P〉0.05）。术后髋关节Harris评分：PFNA组为（82.62±4.76）分,PCCP组为（81.49±4.29）分,2组比较差异无统计学意义（P〉0.05）。2组手术时间比较差异无统计学意义（P〉0.05）。PCCP组术中出血量和伤口引流量显著少于PFNA组、PFNA组下地负重时间少于PCCP组（均P〈0.05）。结论PCCP和PFNA均是治疗股骨粗隆间骨折较好的内固定材料。需根据患者的具体情况,合理地选择内固定方式治疗股骨粗隆间骨折。

Comparison of Proximal Femoral Nail Antirotation and Percutaneous Compression Plating for Intertrochanteric Femur Fractures

Objective To compare the advantages and disadvantages of percutaneous compression plating（PCCP）and proximal femoral nail antirotation（PFNA）in the treatment of intertrochanteric femur fractures.Methods Seventy patients with intertrochanteric fractures were assigned to receive either PFNA（PFNA group,n=38）or PCCP（PCCP group,n=32）for internal fixation.The operative time,intraoperatve blood loss,fracture healing time,postoperative weightbearing time,Harris hip score and incidence of complications were compared between the two groups.Results There were no significant differences in operative time,fracture healing time and incidence of complications between the two groups（P〉0.05）.Postoperative Harris hip score was82.62±4.76in PFNA group and 81.49±4.29in PCCP group.The difference in Harris hip score was not significant between the two groups（P〉0.05）.Compared with PFNA group,intraoperatve blood loss and wound drainage volume decreased but postoperative weight-bearing time increased in PCCP group（P〈0.05）.Conclusion Both PCCP and PFNA are excellent materials for internal fixation in the treatment of intertrochanteric fractures.The method for internal fixation should be reasonably chosen according to the specific situation of patients with intertrochanteric fractures.