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[1]孫群周,阮成群,陳武林,等.股骨近端防旋髓內(nèi)釘內(nèi)固定與股骨近端鎖定鋼板內(nèi)固定治療A2.3型股骨轉(zhuǎn)子間骨折合并大轉(zhuǎn)子外側(cè)壁冠狀面破損的對(duì)比研究[J].中醫(yī)正骨,2021,33(04):9-14.
　SUN Qunzhou,Ruan Chengqun,CHEN Wulin,et al.A comparative study of internal fixation with proximal femoral nail anti-rotation versus proximal femoral locking plate for treatment of type A2.3 femoral intertrochanteric fractures combined with greater trochanteric lateral wall coronal fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(04):9-14.
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股骨近端防旋髓內(nèi)釘內(nèi)固定與股骨近端鎖定鋼板內(nèi)固定治療A2.3型股骨轉(zhuǎn)子間骨折合并大轉(zhuǎn)子外側(cè)壁冠狀面破損的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年04期
頁(yè)碼:
9-14
欄目:
臨床研究
出版日期:
2021-04-20

文章信息/Info

Title:
A comparative study of internal fixation with proximal femoral nail anti-rotation versus proximal femoral locking plate for treatment of type A2.3 femoral intertrochanteric fractures combined with greater trochanteric lateral wall coronal fractures
作者:
孫群周; 阮成群; 陳武林; 李光明
(河南省洛陽(yáng)正骨醫(yī)院/河南省骨科醫(yī)院,河南 洛陽(yáng) 471002)
Author(s):
SUN Qunzhou; Ruan Chengqun; CHEN Wulin; LI Guangming
Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
關(guān)鍵詞:
髖骨折;  轉(zhuǎn)子間骨折;  骨折固定術(shù); 內(nèi);  股骨近端防旋髓內(nèi)釘;  股骨近端鎖定鋼板;  療效比較研究;  臨床試驗(yàn)
Keywords:
hip fractures;  intertrochanteric fractures;  fracture fixation; internal;  proximal femoral nail antirotation;  proximal femoral locking plate;  comparative effectiveness research;  clinical trial
摘要:
目的:比較股骨近端防旋髓內(nèi)釘(proximal femoral nail antirotation,PFNA)內(nèi)固定與股骨近端鎖定鋼板(proximal femoral locking plate,PFLP)內(nèi)固定治療A2.3型股骨轉(zhuǎn)子間骨折合并大轉(zhuǎn)子外側(cè)壁冠狀面破損的臨床療效。方法:回顧性分析2013年5月至2019年8月收治的65例A2.3型股骨轉(zhuǎn)子間骨折合并大轉(zhuǎn)子外側(cè)壁冠狀面破損患者的病例資料。37例采用PFNA內(nèi)固定治療(PFNA組),28例采用PFLP內(nèi)固定治療(PFLP組)。比較2組患者的手術(shù)切口長(zhǎng)度、手術(shù)時(shí)間、術(shù)中出血量、術(shù)后開(kāi)始負(fù)重時(shí)間、骨折愈合時(shí)間及Harris髖關(guān)節(jié)評(píng)分。結(jié)果:①一般指標(biāo)。PFNA組患者手術(shù)切口長(zhǎng)度、術(shù)中出血量均小于PFLP組[(8.05±1.75)cm,(15.05±6.36)cm,t=15.254,P=0.000;(124.50±8.50)mL,(315.50±6.50)mL,t=76.652,P=0.000],手術(shù)時(shí)間、術(shù)后開(kāi)始負(fù)重時(shí)間、骨折愈合時(shí)間均短于PFLP組[(53.50±5.50)min,(74.50±7.60)min,t=27.652,P=0.000;(38.50±1.85)d,(64.50±3.35)d,t=30.746,P=0.000;(11.24±1.22)周,(14.06±1.53)周,t=1.620,P=0.026]。②Harris髖關(guān)節(jié)評(píng)分。時(shí)間因素和分組因素不存在交互效應(yīng)(F=6.352,P=0.109); 2組患者Harris髖關(guān)節(jié)評(píng)分總體比較,差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=5.214,P=0.038); 術(shù)后不同時(shí)間點(diǎn)之間Harris髖關(guān)節(jié)評(píng)分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=6.836,P=0.016); 2組患者Harris髖關(guān)節(jié)評(píng)分隨時(shí)間延長(zhǎng)均呈逐漸升高趨勢(shì),且2組的升高趨勢(shì)一致 [(67.45±4.30)分,(80.35±3.00)分,(88.65±4.20)分,F=4.251,P=0.041;(56.26±2.40)分,(68.25±4.60)分,(78.37±3.30)分,F=7.528,P=0.012]; 術(shù)后3個(gè)月、6個(gè)月、12個(gè)月,PFNA組的Harris髖關(guān)節(jié)評(píng)分均高于PFLP組(t=1.763,P=0.031; t=1.635,P=0.035; t=1.586,P=0.046)。結(jié)論:PFNA內(nèi)固定與PFLP內(nèi)固定治療A2.3型股骨轉(zhuǎn)子間骨折合并大轉(zhuǎn)子外側(cè)壁冠狀面破損,均能促進(jìn)髖關(guān)節(jié)功能恢復(fù),但前者創(chuàng)傷小、骨折愈合快,患者術(shù)后可以較早開(kāi)始負(fù)重。
Abstract:
To compare the clinical curative effects of internal fixation with proximal femoral nail antirotation(PFNA)versus proximal femoral locking plate(PFLP)in treatment of type A2.3 femoral intertrochanteric fractures combined with greater trochanteric lateral wall coronal fractures.Methods:The medical records of 65 patients with type A2.3 femoral intertrochanteric fractures and greater trochanteric lateral wall coronal fractures recruited from May 2013 to August 2019 were analyzed retrospectively.Thirty-seven patients were treated with PFNA internal fixation(PFNA group),while the others were treated with PFLP internal fixation(PFLP group).The incision length,operative time,intraoperative blood loss,postoperative weight-bearing walking start time,fracture healing time and Harris hip scores were compared between the 2 groups.Results:The operative incision was smaller,the intraoperative blood loss was less and the operative time,postoperative weight-bearing walking start time and fracture healing time were shorter in PFNA group compared to PFLP group(8.05±1.75 vs 15.05±6.36 cm,t=15.254,P=0.000; 124.50±8.50 vs 315.50±6.50 mL,t=76.652,P=0.000; 53.50±5.50 vs 74.50±7.60 minutes,t=27.652,P=0.000; 38.50±1.85 vs 64.50±3.35 days,t=30.746,P=0.000; 11.24±1.22 vs 14.06±1.53 weeks,t=1.620,P=0.026).There was no interaction between time factor and group factor in Harris hip scores(F=6.352,P=0.109).There was statistical difference in Harris hip scores between the 2 groups in general,in other words,there was group effect(F=5.214,P=0.038).There was statistical difference in Harris hip scores between different timepoints after the surgery,in other words,there was time effect(F=6.836,P=0.016).The Harris hip scores presented a time-dependent increasing trend in the 2 groups,while both were consistent with each other in the variation tendency(67.45±4.30,80.35±3.00,88.65±4.20 points,F=4.251,P=0.041; 56.26±2.40,68.25±4.60,78.37±3.30 points,F=7.528,P=0.012).The Harris hip scores were higher in PFNA group compared to PFLP group at 3,6 and 12 months after the surgery(t=1.763,P=0.031; t=1.635,P=0.035; t=1.586,P=0.046).Conclusion:Both PFNA and PFLP internal fixation can promote hip function recovery in treatment of type A2.3 femoral intertrochanteric fractures combined with greater trochanteric lateral wall coronal fractures,however,the former has such advantages as less injuries,faster fracture healing and postoperative earlier weight-bearing compared to the latter.

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更新日期/Last Update: 1900-01-01