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[1]張昌猛,孫天勝,任繼鑫,等.亞洲型股骨近端防旋髓內(nèi)釘與InterTan系統(tǒng)治療老年股骨轉(zhuǎn)子間骨折的對(duì)比研究[J].中醫(yī)正骨,2013,25(07):20-23.
　ZHANG Chang-meng*,SUN Tian-sheng,REN Ji-xin,et al.Comparison of proximal femoral nail antirotation-Ⅱand InterTan system for the treatment of intertrochanteric fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(07):20-23.
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亞洲型股骨近端防旋髓內(nèi)釘與InterTan系統(tǒng)治療老年股骨轉(zhuǎn)子 間骨折的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期數(shù):
2013年07期
頁碼:
20-23
欄目:
髖部損傷
出版日期:
2013-07-31

文章信息/Info

Title:
Comparison of proximal femoral nail antirotation-Ⅱand InterTan system for the treatment of intertrochanteric fractures in old patients
作者:
張昌猛1; 孫天勝2; 任繼鑫1; 陰彥斌1; 何紅英1
1.中國(guó)人民解放軍北京軍區(qū)總醫(yī)院全軍創(chuàng)傷骨科研究所,北京 100700; 2.山西醫(yī)科大學(xué)第二臨床醫(yī)學(xué)院,山西 太原 030001
Author(s):
ZHANG Chang-meng*; SUN Tian-sheng; REN Ji-xin; YIN Yan-bin; HE Hong-ying.*
The PLA Orthopaedic Trauma Institute of General Hospital of Beijing Military Region,Beijing 100700,China
關(guān)鍵詞:
髖骨折 骨折固定術(shù); 髓內(nèi) 治療; 臨床研究性
Keywords:
Hip fractures;  Fracture fixation; intramedullary;  Therapies; investigational
摘要:
目的:比較亞洲型股骨近端防旋髓內(nèi)釘和InterTan股骨近端髓內(nèi)釘系統(tǒng)治療老年股骨轉(zhuǎn)子間骨折的臨床療效和安全性。方法:回顧性分析接受手術(shù)治療的68例老年股骨轉(zhuǎn)子間骨折患者的病歷資料,采用亞洲型股骨近端防旋髓內(nèi)釘固定治療者44例(PFNA-Ⅱ組),采用InterTan股骨近端髓內(nèi)釘系統(tǒng)固定者24例(InterTan組)。比較2組患者的手術(shù)時(shí)間、術(shù)中出血量、手術(shù)前后血紅蛋白差值、住院時(shí)間、末次隨訪時(shí)的Harris評(píng)分及術(shù)后并發(fā)癥的發(fā)生情況。結(jié)果:①一般情況。PFNA-Ⅱ組手術(shù)時(shí)間和術(shù)中出血量[(70.81±11.34)min,(135.81±49.05)mL]小于InterTan組[(82.92±16.74)min,(180.80±92.91)mL],差異有統(tǒng)計(jì)學(xué)意義(t=-3.160,P=0.003; t=-2.246,P=0.032)。PFNA-Ⅱ組手術(shù)前后血紅蛋白差值及住院時(shí)間[(20.68±8.49)g·L-1,(11.29±3.33)d]與InterTan組[(24.46±11.12)g·L-1,(11.33±2.77)d]比較,差異無統(tǒng)計(jì)學(xué)意義(t=-1.542,P=0.128; t=-0.047,P=0.962)。②Harris評(píng)分。2組患者均獲隨訪,時(shí)間9～23個(gè)月,中位數(shù)18.5個(gè)月。末次隨訪時(shí)PFNA-Ⅱ組[(83.20±5.03)分]與InterTan組[(85.44±11.14)分]比較,差異無統(tǒng)計(jì)學(xué)意義(t=-0.459,P=0.658)。③安全性。末次隨訪時(shí)PFNA-Ⅱ組有5例患者訴患肢時(shí)有隱痛,InterTan組有2例患者訴患肢時(shí)有隱痛,但均不影響日常活動(dòng)。PFNA-Ⅱ組5例發(fā)生肺部感染; InterTan組3例發(fā)生發(fā)生肺部感染。2組患者均未發(fā)生褥瘡、靜脈血栓栓塞及內(nèi)固定失敗等并發(fā)癥。2組患者并發(fā)癥發(fā)生率比較,差異無統(tǒng)計(jì)學(xué)意義(χ2=0.000,P=1.000)。結(jié)論:亞洲型股骨近端防旋髓內(nèi)釘和InterTan系統(tǒng)都是治療老年股骨轉(zhuǎn)子間骨折的安全有效的治療方式,前者操作更加簡(jiǎn)單。
Abstract:
Objective:To compare proximal femoral nail antirotation-Ⅱ(PFNA-Ⅱ)with InterTan proximal femoral intramedullary nail(PFIN)in the clinical curative effects and safety for the treatment of intertrochanteric fractures in old patients.Methods:The medical records of 68 old patients who underwent surgery for intertrochanteric fractures were analyzed retrospectively.Forty-four patients(PFNA-Ⅱgroup)underwent PFNA-Ⅱfixation,while the others(InterTan group)underwent InterTan PFIN fixation.The 2 groups were compared with each other in such parameters as operative time,blood loss,differences of hemoglobin(HGB)between pre-operation and post-operation,hospital stay,Harris scores at last follow-up and incidence rate of complications.Results:The operative time and blood loss of PFNA-Ⅱgroup were all lower than those of InterTan group respectively[(70.81±11.34)min vs(82.92±16.74)min,t=-3.160,P=0.003;(135.81±49.05)mL vs(180.80±92.91)mL,t=-2.246,P=0.032]; while there were no statistical differences in HGB differences between pre-operation and post-operation and hospital stay between PFNA-Ⅱgroup and InterTan group respectively[(20.68±8.49)g·L-1 vs(24.46±11.12)g·L-1,t=-1.542,P=0.128;(11.29±3.33)d vs(11.33±2.77)d,t=-0.047,P=0.962].The patients in the 2 groups were all followed up for 9 to 23 months with a median of 18.5 months.There was no statistical difference in Harris scores between PFNA-Ⅱgroup and InterTan group at the last follow-up[(83.20±5.03)vs(85.44±11.14),t=-0.459,P=0.658].At last follow-up,5 patients in PFNA-Ⅱ group and 2 patients in InterTan group felt occasional affected limbs vague pain,which didn't influence their daily activities.The pulmonary infection were found in 5 patients in PFNA-Ⅱgroup and 3 patients in InterTan group.No complications including bedsore,venous thromboembolism and failed internal fixation were found in the 2 groups.There was no statistical difference in complication rate between the 2 groups(χ2=0.000,P=1.000).Conclusion:Both PFNA-Ⅱfixation and InterTan PFIN fixation are safe and effective treatment for intertrochanteric fractures in old patients,while the former is relatively easy to operate.

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更新日期/Last Update: 1900-01-01