苏中雷,王文娟,刘金峰,郭云涛,郭新安,段元涛.髓内固定治疗老年性股骨转子间骨折的疗效分析.[J].中南医学科学杂志.,2022,(3):425-428.
髓内固定治疗老年性股骨转子间骨折的疗效分析
Effect of intramedullary fixation on senile femoral intertrochanteric fractures
投稿时间:2021-03-11  修订日期:2021-06-30
DOI:10.15972/j.cnki.43-1509/r.2022.03.029
中文关键词:  Gamma钉  股骨近端防旋髓内钉  联合压力交锁髓内钉  老年性股骨转子间骨折
英文关键词:Gamma nail  PFNA-Ⅱ  InterTan  senile femoral intertrochanteric fracture
基金项目:
作者单位E-mail
苏中雷 创伤关节外科, e-mail为caicai44566@163.com,e-mail为mm933873@163.com 
王文娟 心内科,山东省济南市271104  
刘金峰 创伤关节外科,  
郭云涛 创伤关节外科,  
郭新安 创伤关节外科,  
段元涛 创伤关节外科, e-mail为caicai44566@163.com,e-mail为mm933873@163.com 
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中文摘要:
      目的比较Gamma钉、亚洲型股骨近端防旋髓内钉(PFNA-Ⅱ)、联合压力交锁髓内钉(InterTan)对老年性股骨转子间骨折的治疗效果。方法分析152例老年性股骨转子间骨折患者的临床资料,按髓内固定方式分为Gamma钉组、PFNA-Ⅱ组、InterTan组,并比较相关参数。结果与Gamma钉组比较,PFNA-Ⅱ组和InterTan组手术时间、术中透视次数和出血量及围术期输血量减少(P<0.05);InterTan组骨折愈合时间、住院时间短于Gamma钉组和PFNA-Ⅱ组(P<0.05);术后1个月和12个月InterTan组髋关节功能Harris评分高于Gamma钉组和PFNA-Ⅱ组(P<0.05);以上指标其他组间比较,以及术后24个月3组Harris评分、并发症发生率差异无显著性(P>0.05)。结论老年性股骨转子间骨折治疗需根据患者实际情况而定,PFNA-Ⅱ和InterTan手术操作方便、手术时间短,可减少术中透视次数及术中出血量;而InterTan愈合时间较短,髋关节功能恢复良好。
英文摘要:
      To compare the clinical effects of Gamma nail, Asian proximal femoral nail antirotation-Ⅱ(PFNA-Ⅱ) and interlocking intramedullary nail (InterTan) in the treatment of senile femoral intertrochanteric fractures.MethodsThe clinical data of 152 patients with senile femoral intertrochanteric fractures was analyzed. The patients were divided into Gamma nail group, PFNA-Ⅱ group and InterTan group according to the intramedullary fixation method.Relevant parameters were compared. ResultsCompared with Gamma nail group,surgical time, frequency of intraoperative fluoroscopy, intraoperative blood loss and perioperative blood transfusion volume of PFNA-Ⅱ group and InterTan group were significantly shorter/less (P<0.05), the fracture healing time and hospital stay of InterTan group were shorter than those of Gamma nail group and PFNA-Ⅱ group (P<0.05), the hip function Harris scores of InterTan group were significantly higher than those of Gamma nail group and PFNA-Ⅱ group at 1 month and 12 months after operation (P<0.05), there were no significant difference among other groups in the above indicators, and among the three groups in hip function Harris scores at 24 months after surgery or the incidence of complications (P>0.05). ConclusionsThe treatment of senile femoral intertrochanteric fractures should be based on the patient’s actual condition.PFNA-Ⅱ and InterTan are convenient to operate and the surgical time is short. They can reduce the frequency of intraoperative fluoroscopy and intraoperative blood loss. However, fracture healing time of patients treated with InterTan is shorter, and hip function recovers well.
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