膨胀钉与股骨近端髓内钉固定治疗高龄股骨转子间骨折的比较分析

目的：比较膨胀髓内钉（Fixion PF）与股骨近端髓内钉（PFN）内固定治疗股骨转子间骨折的临床疗效。方法：采用前瞻性研究，将2005年5月-2007年2月收治的51例股骨转子间骨折患者随机分为膨胀钉组和PFN组，记录两组的手术时间、术中失血量、切口长度、影像增强仪曝光时间、术后住院时间和骨折愈合时间并进行比较。结果：膨胀钉组平均手术时间、失血量、切口长度分别为77．20min，104．20mL和5．12cm，均明显低于PFN组（分别为108．84min，240．38mL和11．79cm），差异有显著性意义（P〈O．01）；膨胀钉组影像增强仪曝光时间低于PFN组（P〈0．01）；两组患者骨折临床愈合时间和平均住院时间无显著差异（P〉0．05）。两组所有骨折均愈合，无延迟愈合与不愈合。结论：与股骨近端髓内钉（PFN）内固定方法相比，膨胀髓内钉治疗股骨转子间骨折是一种更加微创的内固定手段，早期临床疗效更令人满意。

Comparison of Expandable Intradullary Nail System and Proximal Femoral Nail in the Treatment of Intertrochanteric Fractures

Objective： To compare the effects of expandable intramedullary nail system （Fixion PF） and proximal femoral nail （PFN） in the treatment of intertrochanteric fractures. Methods： From May. 2005 to Feb. 2007, fifty-one patients with intertrochanteric fractures were randomly distributed into Fixion PF group and PFN group. The operation time, intra-oper- ative blood loss, length of incision, X-ray exposure, duration of in--patient stay and time of bone union in both groups were recorded and compared. Results： The mean operation time, intraoperative blood loss and length of incisions in Fixion PF group were respectively 77.20 min, 104.20 ml and 5.12 cm, which were significantly lower than those in PFN group （P（0. 01）, with respective data 108.84 min, 240.38 ml and 11.79 cm. The X-ray exposure and the reduction time in PFN group lasted longer than in Fixion PF group （P（0.01）. There were no differences in mean time of bone union and in --patient stay in both groups （P~0.05）. At the latest follow--up, all the fractures united in both groups without nonunion or delayed union. Conclusion： Compared with PFN protocol, introduction of Fixion PF displayed superiority in micro-- invasion at early clinical stage.