Objective To compare the effect of proximal femoral locking plate and proximal femoral nail fixation on the treatment of senile unstable pertrocchanteric osteoporotic fractures. Methods One hundred and fifty-nine patients, who had senile unstable pertrocchanteric osteoporotic fractures, were randomly divided into 2 groups: locking plate group ( n = 80) and proximal femoral nail ( PFN) group ( n =79). Patients in locking plate group were treated with proximal locking plate for medullary external fixation treatment, and patients in PFN group were treated with proximal femoral intramedullary nail fixation treatment. The effect between the groups was compared and analyzed. Results The operation time, bleeding volume during operation, and postoperative Harris scores in PFN group showed no significant difference with that in locking plate group ( P ＞ 0. 05 ). The excellent rate and the incidence of complications in locking plate group was obviously superior to that in PFN group, and the difference was significant ( P ＜ 0. 05). Conclusion Both proximal femoral locking plate and proximal femoral nail fixation have obvious effect on type Ⅰ, type Ⅱ, and type Ⅲ fractures. Patients with type Ⅳ fractures should be treated with proximal femoral locking plate.%目的 探讨股骨近端锁定钢板和髓内钉钢板固定治疗老年不稳定性股骨转子骨质疏松性骨折的疗效比较.方法 将本院159例老年不稳定性股骨转子骨质疏松性骨折患者随机分成锁定钢板组(80例)与股骨近端髓内钉组(PFN)(79例),锁定钢板组采用股骨近端锁定钢板进行髓外固定治疗,PFN组组采用股骨近端髓内钉内固定治疗,并对疗效进行比较分析.结果 PFN组患者的手术时间、术中出血量及术后Harris评分与锁定钢板组患者无统计学意义(P＞0.05).锁定钢板组患者优良率与并发症发生率明显优于股骨近端髓内钉组组,差别有统计学意义(P＜0.05).结论 Ⅰ型、Ⅱ型、Ⅲ型骨折患者采用股骨近端锁定钢板与PFN组治疗,疗效均显著,若为Ⅳ型骨折患者尽量采用股骨近端锁定钢板治疗.
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