目的 比较股骨近端防旋髓内钉(proximal femoral nail antirotation, PFNA)与股骨近端髓内钉InterTan?治疗老年患者股骨转子间骨折的疗效.方法 选取2014年3月-2017年3月成都市第一人民医院骨科收治的股骨转子间骨折老年患者123例进行回顾性分析,根据所采用的器械分为PFNA组(61例)和InterTan组(62例).比较两组手术时间,术中出血量,术前、术后1周和6个月患髋美国特种外科医院(hospital forspecialsurgery,HSS)评分.结果 术前两组一般资料差异无统计学意义.PFNA组手术时间、术中出血量、术后1周患髋HSS评分均低于InterTan组,两组差异有统计学意义(P＜ 0.05);两组术后6个月患髋HSS功能评分差异无统计学意义(P＞0.05).结论 对于非重度骨质疏松无明显头钉切割风险的老年患者,PFNA可作为股骨转子间骨折治疗方案的优先选择.%Objective To compare the effect of proximal femoral nail antirotation (PFNA) versus proximal femoral nail InterTan(R) in the treatment of intertrochanteric fractures in elderly patients. Methods A total of 123 patients with femoral intertrochanteric fractures were selected from March 2014 to March 2017 in the First People's Hospital of Chengdu, and were divided into group PFNA (n=61) and group InterTan (n=62) by nailing system used in surgery. The operating time, intraoperative blood loss, hip hospital for special surgery (HSS) score before surgery and at one week and six months after surgery were observed. Results There was no significant difference in baseline data between two groups. The operating time [(48.3±10.2) min vs (84.2±15.6) min], intraoperative blood loss [(108.4±12.7) ml vs (175.3±27.2) ml] and the HSS score [(62.4±4.5) vs (68.8±6.7)] at one week after operation in group PFNA were significantly lower than those in group InterTan (all P ＜ 0.05). However, there was no significant difference in HSS score at six months after operation between two groups (P ＞ 0.05). Conclusion PFNA is an optimal choice for elderly patients with intertrochanteric fractures if patients haven't severe osteoporosis and obvious risk of nail cutting.
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