锁定钢板与PFNA治疗股骨粗隆间骨折的对比分析

目的比较锁定钢板与改良股骨近端加锁髓内钉（PFNA）2种内固定方式治疗股骨粗隆间骨折的临床疗效。方法根据不同年龄段和骨折分型,对138例股骨粗隆间骨折患者分别采用股骨近端解剖型锁定钢板（解剖型锁定钢板组,n=63）及PFNA（PFNA组,n=75）进行内固定。对2组围术期指标和术后髋关节功能恢复程度进行比较。结果 2组患者均获随访7～36个月。2组切口大小、出血量、颈干角减少、平均愈合时间比较,差异有统计学意义（P〈0.05）。2组骨折手术时间、术后髋关节功能比较,差异无统计学意义（P〉0.05）。结论 2种内固定方法临床效果相当,但与股骨近端解剖型锁定钢板比较,PFNA创伤小、出血量少、卧床时间短。

Comparison of Locking Plate and PFNA for Intertrochanteric Fractures

Objective To compare the clinical effects of locking plate and PFNA in the treatment of intertrochanteric fractures.Methods A total of 138 cases of intertrochanteric fractures were treated with anatomical proximal femoral locking plate（locking plate group,n=63） and modified proximal femoral intramedullary nails（PFNA group,n=75） according to age and modified Evans classification.Perioperative indicators and degree of functional recovery of hip after surgery were compared between the two groups.Results All patients were followed up for 7-36 months.There were significant differences in cut size,amount of bleeding,reduction of neck shaft angle,and average healing time between locking plate group and PFNA group（P0.05）,but the differences in operation time and postoperative hip function were not significant between the two groups（P0.05）.Conclusion PFNA is a better choice than proximal femoral anatomical locking plate in the treatment of intertrochanteric fractures due to smaller incisions,less blood loss and shorter time in bed.