To compare the therapeutic efficacy of PFNA fixation and hemiarthroplasty in the treatment of elderly patients are made with unstable intertrochanteric fracture. 63 patients were divided into PFNA fixation group and the hemiarthroplasty group. Conventional surgical approach were adopted in both groups. Hip function after surgery, surgical time, blood loss,weight-bearing ambulation after surgery and complications were observed. There was no significant difference of complication between the two groups ( P > 0. 05 ). Postoperative Harris hip score of the hemiarthroplasty group was better than that of PFNA fixation group (P <0. 01)after 1,3 months, however, there was no significant difference of hip function between the two groups ( P > 0.05) after 6, 12 months. There were significantly shorter time before weight-bearing ambulation after surgery and more blood loss in the hemiarthroplasty group ( P < 0. 05 ). Two surgical procedures are effective in the treatment of elderly patients with unstable intertrochanteric fracture. The operation method should be chosed accord the body condition of patients and fracture type.%评价PFNA内固定与人工股骨头置换治疗高龄不稳定型股骨粗隆间骨折疗效.本组患者共63例,分为PFNA内固定组和人工股骨头置换组,两组均采用常规手术入路.观察两组患者的术后髋关节功能、手术时间、出血量、术后下地负重时间及并发症等指标.两组并发症发生率比较,差异无统计学意义(P＞0.05).人工股骨头置换组术后1、3月髋关节Harris评分优于PFNA组(P＜0.01),术后6月、1年两组患者髋关节功能无明显差异.人工股骨头置换组术后下地负重时间早于PFNA组,术中出血量多于PFNA组(P＜0.05).对于高龄不稳定型股骨粗隆间骨折的治疗,两种内固定方式均有较好的疗效,手术方式应根据患者自身情况及骨折类型选择.
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