中国组织工程研究2017，Vol.21Issue(31)：4995-5000,6.DOI:10.3969/j.issn.2095-4344.2017.31.013
经皮加压钢板与股骨近端防旋髓内钉内固定治疗老年稳定性股骨转子间骨折:术后功能恢复、股骨头旋转及固定钉滑脱的比较
Effects of percutaneous compression plateversus proximal femoral nail anti-rotation internal fixation on the postoperative functional recovery and femoral head rotation and nail slippage in elderly patients with stable intertrochanteric fracture
摘要
Abstract
BACKGROUND: Senile unstable intertrochanteric fractures are usually treated with intramedullary nail fixation, but for stable intertrochanteric fractures, extramedullary fixation and intramedullary nail both can obtain satisfactory curative efficacy. Therefore, surgical options are still a controversy.OBJECTIVE: To investigate the effect of percutaneous compression plate (PCCP) versus proximal femoral nail anti-rotation (PFNA) on the postoperative functional recovery of the elderly with stable intertrochanteric fractures and to observe the rotational stability and nail slipping.METHODS: Totally 86 elderly patients with stable intertrochanteric fracture were randomly divided into two groups, and then underwent PCCP or PFNA. The operation time, intraoperative blood loss, postoperative hemoglobin level, the time of weigh bearing, and fracture healing time were recorded; Harris hip scores at postoperative 4 weeks were detected to assess the functional recovery; the rotation rate of femoral head and incidence of nail slipping at 4 weeks postoperatively,as well as the complications within 6 months postoperatively were analyzed statistically.RESULTS AND CONCLUSION: (1) The intraoperative and postoperative declined levels of hemoglobin in the PFNA group were significantly higher than those in the PCCP group (P < 0.05). (2) There was no significant difference for in the Harris hip scores between two groups at postoperative 4 weeks (P > 0.05). The weight bearing time and fracture healing time in the PFNA group were significantly shorter than those in the PCCP group (P < 0.05). (3) The rotation rate of femoral head and nail slipping in the PFNA group were significantly lower than those in the PCCP group (P < 0.05). (4) The incidence of complications within 6 months postoperatively did not differ significantly between two groups (P > 0.05).(5) These results suggest that there is no significant difference in the postoperative function recovery and complications between PCCP and PFNA in the treatment of senile femoral intertrochanteric fracture fixation. However, PFNA possesses advantages in the rotation rate of femoral head and nail slipping.关键词
骨科植入物/骨植入物/经皮加压钢板/股骨近端防旋髓内钉/股骨转子间骨折/功能恢复/股骨头旋转/固定钉滑脱分类
医药卫生引用本文复制引用
张磊,周正明,顾家烨,殷小军,陆栋..经皮加压钢板与股骨近端防旋髓内钉内固定治疗老年稳定性股骨转子间骨折:术后功能恢复、股骨头旋转及固定钉滑脱的比较[J].中国组织工程研究,2017,21(31):4995-5000,6.基金项目
2012年江苏省卫生厅医学新技术引进二等奖(苏卫科教(2012)11号),引进技术名称:经皮加压钢板(PCCP)治疗老年股骨转子间骨折的临床应用 the Second Prize in New Medical Technology Introduction of Jiangsu Provincial Department of Health in 2012, No. (2012)11 （苏卫科教(2012）
