目的：分析比较股骨近端螺旋髓内钉（HPFN）和螺杆髓内钉（SPFN）内固定治疗股骨转子间骨折的手术疗效和安全性。方法83例股骨转子间骨折的患者中43例采用HPFN内固定治疗，40例采用SPFN内固定治疗。记录并比较两组患者平均手术时间、术中出血量、术后下床活动时间、骨折愈合时间、颈干角改变及并发症等情况，并对患者进行影像学评估、随访及术后功能性及活动性评估。结果 HPFN组患者社会功能评分及活动性评分均明显高于SPFN组患者，而并发症发生率低于SPFN组患者，差异均有统计学意义（P＜0.05或0.01）。两组患者平均手术时间、术中出血量、骨折愈合时间、术后下床活动时间及颈干角改变等的差异无统计学意义（均P＞0.05）。结论 HPFN和SPFN均是治疗股骨转子间骨折的合适内固定器材，而HPFN在患者术后功能恢复及减少并发症方面优于SPFN。%Objective To compare the efficacy and safety of helical and screw proximal femoral nails (HPFN, SPFN) in treatment of intertrochanteric fractures. Methods Eighty- three patients with intertrochanteric fractures were enrol ed. Among them, 43 patients were treated with HPFN and 40 patients were treated with SPFN. The assessments of mean operative time, in-traoperative blood loss, postoperative ambulation time, healing time, the neck- shaft angle changes, complications, the radio-graphic evaluation, postoperative function and activities were performed. Results HPFN was better in terms of social function scores, mobility scores, and complication rates with statistical significance. No significant differences were found between HPFN and SPFN in terms of mean operative time, intraoperative blood loss, postoperative ambulation time, healing time, the neck- shaft angle changes. Conclusion HPFN and SPFN are both suitable implants for the treatment of intertrochanteric fractures, but HPFN has better postoperative functional recovery and lower complication rate than SPFN.
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