PFNA与Gamma钉治疗股骨干骨折合并同侧股骨近端骨折的比较研究

目的研究股骨近端防旋髓内钉(PFNA)与伽马(Gamma)钉在股骨骨折中的疗效。方法回顾22例股骨干,骨折合并股骨近端骨折患者,其中8例使用加长型PFNA固定(观察组),14例给予加长GammaⅡ型钉固定(对照组),观察治疗效果、负面情绪、生活活动能力和髋关节功能。结果观察组总有效率为100.0%,高于对照组的64.3%(p<0.05);观察组手术操作时间、术中出血量、术后并发症较对照组少(P<0.05),但骨折愈合时间无显著差异(p>0.05);观察组VAS疼痛评分、lAMA评分、HAMID评分均明显低于对照组(P<0.05);Barthel评分、Harris评分均明显高于对照组(P<0.05)。结论股骨干合并股骨颈骨折应用PFNA,较GammaⅡ型钉治疗更具积极意义。

Effects of PFNA and Gamma nail in treatment of femoral shaft fracture combined with ipsilateral fractures of the proximal femur

Objective To study the effects of PFNA and Gamma nail in treatment of femoral shaft fracture combined with ipsilateral fractures of the proximal femur.Methods 22 patients with femoral shaft fracture combined with ipsilateral fractures of the proximal femur were collected and randomly divided into observation group given extended PFNA fixation and control group given extended GammaⅡfixation.Then the curative effect,negative emotions,activities and the function of hip joint were observed.Results The total efficiency of PFNA was significantly better than Gamma nail(100.0%vs 64.3%, P < 0.05);operation time,intra-operative bleeding,postoperative complications of PFNA were less than Gamma nail(P < 0.05);VAS score,HAMA,HAMD score were significantly lower than those in Gamma nail(P < 0.05);Barthel score, Harris score were significantly higher than those in Gamma nail(P <0.05).Conclusion PFNA has more positive significance than GammaⅡtype nail in treatment of femoral shaft fracture combined with ipsilateral fractures of the proximal femur.