摘要
目的比较股骨近端防旋髓内钉（PFNA）治疗老年股骨转子问骨折时两种常用螺旋刀片安置位置的疗效。方法刚顾性分析2010年1月至2012年12月应用PFNA治疗的166例股骨转子间骨折患者资料，按术后X线片显示螺旋刀片在股骨头的位置不同分为2组：C／C组（螺旋刀片正位及侧位均处于股骨头中心位置）87例，1／C组（螺旋刀片正位处于股骨头下1／3位置、侧位处于股骨头中心位置）79例。，两组患者术的一般资料的比较差异均无统计学意义（P〉0．05），具有可比性。比较两组患者的骨折复位质量、尖顶距（TAD）、术后完全负重时间、骨折愈合时间及末次随访时髋关节Harris评分等。，结果C／C组83例患者术后获平均13．6个月随访。I／C组76例患者术后扶平均13．3个月随访。C／C组与I／C组患者的骨折复位优良率分别为94．0％（78／83）、94．7％（72／76），术后完全负重时间平均分别为（9．4±1．5）、（9．3±1．3）周，骨折愈合时问平均分别为（17．8±2．3）、（17．2±2．3）周，末次随访时髋关节Harris评分平均分别为（89．6±4．6）、（89．3±4．7）分，以上项日两组间比较差异均无统计学意义（P〉0．05）。C／C组与I／C组患者的TAD平均分别为（21．14±3．17）、（24．96±3．48）mm，差异有统计学意义（t=-7。242，P=0．000）。两组无一例患者发生感染、螺旋刀片切出或退出等并发症。结论PFNA治疗老年股骨转子间骨折时螺旋刀片的两种安置位置均可取得良好效果，无显著差异。
Objective To compare the clinical effects of 2 common installation positimls of the helical blade in the treatment of senile intertrochanteric fractures with proximal femoral nail antirotation （PFNA） . Methods From January 2010 to December 2012, 166 old patients with interlrochanteric fracture were treated by PFNA. According to the installation position of the helical blade in the femoral head on the postoperative X-ray films, they were divided into a C/C group （87 cases） where the helical blade was at the center of the femoral head in both anteroposterior anti lateral views and an I/C group （79 cases） where the helical blade was at the inferior one-third of the femoral head in anteroposterior view and at the center in lateral view. There were no significant differences between the 2 groups in general data preoperation （ P 〉 0.05） . The 2 groups were compared in terms of reduction quality, tip-apex distance （TAD）, full weight bearing time, fracture healing time, and Harris Hip Score（HHS） at the last follow-up. Results C/C group had 83 patients followed for an average of 13.6 months and I/C group had 76 patients followed for an average of 13.3 months. There were no significant differences between the 2 groups regarding the good-to-excellent reduction rate [94. 0% （78/83） versus 94.7% （72/76） ], full weight bearing time （9.4 ± 1. 5） weeks versus 9.3 ± 1. 3 weeks）, fracture healing time （ 17.8± 2.3 weeks versus 17.2 ± 2.3 weeks）, or HHS （89.6 ±4.6 points versus 89.3 ±4. 7 points） （ P 〉 0.05）. There was a significant difference in TAD （21. 14 ± 3. 17 mm versus 24. 96 ± 3.48 ram） between the 2 groups（ t = - 7. 242, P = 0. 000）. No infection or cut-out or other related complications of the helical blade occurred in either group. Conclusion The helical blade may lead to satisfactory clinical effects in the treatment of senile intertrochanteric fractures with PFNA no matter at which of the 2 positions it is installed.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2014年第2期93-97,共5页
Chinese Journal of Orthopaedic Trauma
关键词
髋骨折
骨折固定术
髓内
骨钉
螺旋刀片
Hip fractures
Fracture fixation, intramedullary
Bone nails
Helical blade
