抗旋髓内钉与股骨加长型第3代Gamma钉治疗老年股骨转子间骨折疗效比较

摘要

Objective To compare the curative effect of two kinds of fixation methods of prolonged third generation of Gamma nail (PTGN) and proximal femoral nail anti-rotation (PFNA) in the treatment of intertrochanteric fractures in the elderly .Methods A total of 78 elderly patients with intertrochanteric fractures were selected from March 2015 to April 2016 .They were divided in-to PTGN group(41 cases) and PFNA group(37 cases) according to the fixation method .The operative time ,intraoperative blood loss ,postoperative weight loading time ,fracture healing time ,hip function and postoperative complication rate were compared be-tween the two groups .Results There were no statistically significant differences on the time of operation ,the time of postoperative weight loading time and the fracture healing time between PFNA and PTGN group (P>0 .05) ,but the intraoperative blood loss of PFNA group was lower than that of PTGN group ,and the difference is statistically significant (P<0 .05) .The excellent rate of hip joint function in PFNA group was significantly higher than that in PTGN group (P<0 .05) .However ,there was no statistically sig-nificant difference in the incidence rate of adverse reactions between the two groups (P>0 .05) .Conclusion The clinical efficacy of PFNA fixation treatment for femoral intertrochanteric fractures in the elderly is better than that of PTGN ,which shows less intrao-perative blood loss ,and a excellent rate of hip joint function .%目的 比较股骨加长型第3代Gamma钉(PTGN)和抗旋髓内钉(PFNA)两种固定方法治疗老年股骨转子间骨折的疗效.方法 选取2015年3月至2016年4月该院收治的78例老年股骨转子间骨折患者作为受试对象,按照固定方法的不同分为PTGN组(41例)和PFNA组(37例),比较两组患者手术时间、术中出血量、术后负重时间、骨折愈合时间、髋关节功能和术后并发症发生率.结果 PFNA组患者手术时间、术后负重时间、骨折愈合时间与PTGN组比较,差异均无统计学意义(P>0.05);但PFNA组术中出血量较PTGN组明显减少,差异有统计学意义(P<0.05);PFNA组患者髋关节功能优良率明显高于PTGN组,差异有统计学意义(P<0.05);而两组患者术后并发症发生率比较,差异无统计学意义(P>0.05).结论 PFNA固定治疗老年股骨转子间骨折较PTGN临床疗效好,术中出血量少,髋关节功能优良率高.