目的:探讨与比较P FNA内固定和关节置换治疗高龄不稳定型转子间骨折的疗效.方法:收集2013年10月至2016年10月入院的150例高龄不稳定型转子间骨折患者随机分为两组,内固定组患者给予P FNA内固定术,关节置换组患者予以关节置换术,比较两组患者治疗前后围手术期临床指标、并发症、关节功能恢复与远期生活质量.结果:内固定组患者手术时间、术中出血量、术后引流量、术后负重时间与骨折愈合时间均低于关节置换组;治疗后1年各维度生活质量评分组间比较均高于关节置换组,差异具有统计学意义(P<0.01);总体并发症发生率低于对照组;关节功能优良率高于关节置换组,差异具有统计学意义(P<0.05).结论:相比较关节置换术,PFNA内固定术对高龄不稳定型转子间骨折患者的临床疗效更为显著,具有借鉴意义.%Objective:To investigate and compare the efficacy of PFNA internal fixation and arthroplasty in treatment of unstable intertrochanteric fractures in elderly patients. Methods:A total of 150 patients with unstable intertrochanteric fractures admitted from October 2013 to October 2016 were randomly divided into two groups. The patients in the internal fixation group received PFNA internal fixation. The patients in the joint replacement group were treated with arthroplasty. Perioperative clinical indexes, complications, recovery of joint function and long-term quality of life of the two groups before and after treatment. Results:The operation time, intraoperative blood loss, postoperative drainage, postoperative weight-bearing time and fracture healing time were significantly lower in the patients in the internal fixation group than those in the joint replacement group. The quality of life scores in each dimension were significantly different There was significant difference between the two groups ( P <0.01) . The overall complication rate was significantly lower than that of the con-trol group. The rate of joint function was significantly higher than that of the joint replacement group ( P <0. 05) . Conclusion:Compared with the arthroplasty, the clinical efficacy of PFNA internal fixation in patients with unstable intertrochanteric fractures is more significant and has reference value.
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