两种内固定治疗股骨转子间骨折的疗效比较

目的比较股骨近端防旋髓内钉(PFNA)与新一代髓内钉(InterTAN)治疗股骨转子间骨折的疗效。方法将96例股骨转子间骨折患者按照随机数字表法分为PFNA组和InterTAN组,各48例。比较两组手术时间、术中出血量、住院时间、骨折愈合时间、扶拐时间、术后6个月Harris髋关节评分以及术后并发症。结果患者均获得随访,时间6~18个月。手术时间、术中出血量、骨折愈合时间PFNA组均短(少)于InterTAN组(P<0.05)。住院时间、扶拐时间、术后6个月Harris髋关节评分两组比较差异均无统计学意义(P>0.05)。术后并发症发生率PFNA组低于InterTAN组(P<0.05)。结论PFNA与InterTAN内固定治疗股骨转子间骨折均具有良好治疗效果,但PFNA较InterTAN具有手术时间短、术中出血量少、并发症发生率低、骨折愈合时间短的优点。

Effect comparison of two kinds of internal fixation for femoral intertrochanter fracture

Objective To compare the therapeutic effect of femoral intertrochanter fracture treated by proximal femoral nail antirotation(PFNA)and new generation of proximal femoral intramedullary nail(TriGen InterTAN hip fracture nailing system,InterTAN).Methods The 96 patients with femoral intertrochanter fractures were divided into two groups according to the method of random number table,PFNA group had 48 cases,InterTAN group had 48 cases.The duration of operation,intraoperative bleeding volume,hospital stay,fracture healing time,crutching time,Harris hip score at 6 months and postoperative complications in the two groups were compared.Results All patients were followed up for 6~18 months.The operation time,intraoperative bleeding volume,fracture healing time in the PFNA group were all shorter(less)than those of InterTAN group(P<0.05).There were no significant differences in hospitalization time,crutching time and Harris hip score at 6 months between the two groups(P>0.05).The incidence rate of postoperative complications in the PFNA group was lower than that of the InterTAN group(P<0.05).Conclusions PFNA and InterTAN internal fixation in the treatment of intertrochanteric fractures have good therapeutic effect,but PFNA has the advantages of shorter operation time,less blood loss,lower incidence of complications and shorter fracture healing time than InterTAN.