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[1]鄭艷峰,吳勛,周榮昌,等.股骨近端防旋髓內(nèi)釘內(nèi)固定與動力髖螺釘內(nèi)固定治療 老年股骨轉(zhuǎn)子間骨折的對比研究[J].中醫(yī)正骨,2015,27(04):24-28.
　ZHENG Yanfeng,WU Xun,ZHOU Rongchang,et al.A comparative study of proximal femoral nail antirotation internal fixation versus dynamic hip screw internal fixation for treatment of intertrochanteric fractures in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(04):24-28.
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股骨近端防旋髓內(nèi)釘內(nèi)固定與動力髖螺釘內(nèi)固定治療 老年股骨轉(zhuǎn)子間骨折的對比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年04期
頁碼:
24-28
欄目:
臨床研究
出版日期:
2015-04-30

文章信息/Info

Title:
A comparative study of proximal femoral nail antirotation internal fixation versus dynamic hip screw internal fixation for treatment of intertrochanteric fractures in the aged
作者:
鄭艷峰; 吳勛; 周榮昌; 陳有芬; 朱家駿
浙江省金華市人民醫(yī)院,浙江 金華 321000
Author(s):
ZHENG Yanfeng; WU Xun; ZHOU Rongchang; CHEN Youfen; ZHU Jiajun
Jinhua People's Hospital,Jinhua 321000,Zhejiang,China
關(guān)鍵詞:
髖骨折;  骨折固定術(shù); 內(nèi);  內(nèi)固定器;  股骨近端防旋髓內(nèi)釘;  動力髖螺釘;  老年人;  治療; 臨床研究性
Keywords:
hip fractures;  fracture fixation; internal;  internal fixators;  proximal femoral nail antirotation;  dynamic hip screw;  aged;  therapies; investigational
摘要:
目的:比較股骨近端防旋髓內(nèi)釘(proximal femoral nail antirotation,PFNA)內(nèi)固定和動力髖螺釘(dynamic hip screw,DHS)內(nèi)固定治療老年股骨轉(zhuǎn)子間骨折的臨床療效和安全性。方法:回顧性分析280例股骨轉(zhuǎn)子間骨折患者的病例資料,其中采用PFNA內(nèi)固定180例,采用DHS內(nèi)固定100例。男169例,女111例; 年齡61～77歲,中位數(shù)65歲; 按照股骨轉(zhuǎn)子間骨折的Evans分型,Ⅰ型62例、Ⅱ型73例、Ⅲ型73例、Ⅳ型72例。比較2組患者的切口長度、出血量、手術(shù)時間、引流量、臥床時間、骨折愈合時間及并發(fā)癥發(fā)生情況,并于術(shù)后6個月比較2組患者的臨床療效。結(jié)果:①一般指標(biāo)。PFNA組的切口長度、出血量、引流量均小于DHS組[(4.44±1.49)cm,(6.34±2.44)cm,t=3.737,P=0.034;(205.25±24.54)mL,(298.29±28.64)mL,t=4.055,P=0.028;(64.46±10.67)mL,(105.11±19.84)mL,t=4.874,P=0.020],其手術(shù)時間、臥床時間、骨折愈合時間均短于DHS組[(68.68±14.43)min,(96.44±11.25)min,t=4.462,P=0.022;(34.51±7.88)d,(53.38±8.59)d,t=5.448,P=0.016;(3.22±1.13)月,(4.07±1.85)月,t=4.366,P=0.025]。②臨床療效。PFNA組優(yōu)110例、良59例、可10例、差1例,DHS組優(yōu)55例、良30例、可10例、差5例; 2組患者的臨床療效比較,差異無統(tǒng)計學(xué)意義(Z=-1.495,P=0.135)。③安全性。PFNA組1例患者術(shù)后切口感染,3例患者骨折畸形愈合,4例患者下肢深靜脈血栓形成; DHS組3例患者術(shù)后切口感染,2例患者內(nèi)固定斷裂,4例患者骨折畸形愈合,3例患者下肢深靜脈血栓形成。PFNA組并發(fā)癥發(fā)生率低于DHS組(χ2=5.533,P=0.019)。結(jié)論:對于老年股骨轉(zhuǎn)子間骨折患者而言,雖然PFNA內(nèi)固定與DHS內(nèi)固定在臨床療效方面無明顯差異,但PFNA內(nèi)固定具有手術(shù)切口小、出血量和引流量少、手術(shù)時間短、骨折愈合快、患者臥床時間短、并發(fā)癥少的優(yōu)點,是治療股骨轉(zhuǎn)子間骨折的一種較理想的方法,值得臨床推廣應(yīng)用。
Abstract:
Objective:To compare the clinical curative effects and safety of proximal femoral nail antirotation(PFNA)internal fixation versus dynamic hip screw(DHS)internal fixation in the treatment of intertrochanteric fractures in the aged.Methods:The medical records of 280 patients with intertrochanteric fractures were analyzed retrospectively.One hundred and eighty patients were treated with PFNA internal fixation(PFNA group),while the others were treated with DHS internal fixation(DHS group).The patients consisted of 169 males and 111 females,and ranged in age from 61 to 77 years(Median=65 yrs).According to the Evans classification of intertrochanteric fractures,the fractures belonged to typesⅠ(62),Ⅱ(73),Ⅲ(73)and Ⅳ(72).The incision length,blood loss,operative time,volume of drainage,bed rest time,fracture healing time and complications were compared between the 2 groups,and the clinical effects were also compared between the 2 groups at 6 months after surgery.Results:The incision length,blood loss and volume of drainage of PFNA group were less than those of DHS group(4.44+/-1.49 vs 6.34+/-2.44 cm,t=3.737,P=0.034; 205.25+/-24.54 vs 298.29+/-28.64 mL,t=4.055,P=0.028; 64.46+/-10.67 vs 105.11+/-19.84 mL,t=4.874,P=0.020),and the operative time,bed rest time and fracture healing time were also shorter in PFNA group compared to DHS group(68.68+/-14.43 vs 96.44+/-11.25 min,t=4.462,P=0.022; 34.51+/-7.88 vs 53.38+/-8.59 days,t=5.448,P=0.016; 3.22+/-1.13 vs 4.07+/-1.85 months,t=4.366,P=0.025).One hundred and ten patients obtained an excellent result,59 good,10 fair and 1 poor in the PFNA group; while 55 patients obtained an excellent result,30 good,10 fair and 5 poor in the DHS group.There was no statistical difference in clinical effects between the 2 groups(Z=-1.495,P=0.135).Incision infection(1 case),fracture malunion(3 cases)and lower extremity deep venous thrombosis(4 cases)were found in PFNA group; while incision infection(3 case),breakage of internal fixation(2 cases),fracture malunion(4 cases)and lower extremity deep venous thrombosis(3 cases)were found in DHS group.The incidence rate of complications of PFNA group was lower than that of DHS group(χ2=5.533,P=0.019).Conclusion:There are no significant difference in clinical curative effects between PFNA internal fixation and DHS internal fixation,however,PFNA internal fixation is an ideal method for treatment of intertrochanteric fractures in the aged for small incision,less blood loss and volume of drainage,shorter operative time,shorter fracture healing time,shorter bed rest time and less complications,so it is worthy of popularizing in clinic.

參考文獻/References:

[1] Yeung M,Bhandari M.Uneven global distribution of randomized trials in hip fracture surgery[J].Acta Orthop,2012,83(4):328-333.
[2] Evans EM.The treatment of trochanteric fractures of the femur[J].J Bone Joint Surg,1949,31(2):190-203.
[3] O'malley NT,Deeb AP,Bingham KW,et al.Outcome of the dynamic helical hip screw system for intertrochanteric hip fractures in the elderly patients[J].Geriatr Orthop Surg Rehabil,2012,3(2):68-73.
[4] 廖紅波,田野.解剖型鎖定鋼板固定治療股骨粗隆部粉碎骨折[J].實用骨科雜志,2011,17(3):250-252.
[5] Setiobudi T,Ng YH,Lim CT,et al.Clinical outcome following treatment of stable and unstable intertrochanteric fractures with dynamic hip screw[J].Ann Acad Med Singapore,2011,40(11):482-487.
[6] 朱一鵬,秦磊.骨質(zhì)疏松高齡患者粗隆間骨折的PFNA治療觀察[J].現(xiàn)代中西醫(yī)結(jié)合雜志,2013,22(25):2779-2780.
[7] Zeng C,Wang YR,Wei J,et al.Treatment of trochanteric fractures with proximal femoral nail antirotation or dynamic hip screw systems:a meta-analysis[J].J Int Med Res,2012,40(3):839-851.
[8] 錢明權(quán),朱國興,陳剛.動力髖螺釘聯(lián)合防旋阻擋釘與股骨近端髓內(nèi)釘治療不穩(wěn)定型股骨粗隆間骨折的對比研究[J].中國矯形外科雜志,2013,21(10):957-962.
[9] Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fratures:Treatment by mold arthroplasty[J].J Bone Joint Surg Am,1969,51(4):737-755.
[10] Fitzpatrick DC,Sheerin DV,Wolf BR,et al.A randomized,prospective study comparing intertrochanteric hip fracture fixation with the dynamic hip screw and the dynamic helical hip system in a community practice[J].Iowa Orthop J,2011,31:166-172.
[11] 樊仕才,金大地,蘇訓(xùn)同,等.老年股骨粗隆間骨折術(shù)后再發(fā)對側(cè)粗隆間骨折的原因分析及治療策略[J].中華關(guān)節(jié)外科雜志:電子版,2010,4(4):477-481.
[12] Cheng T,Zhang G,Zhang X.Review:minimally invasive versus conventional dynamic hip screw fixation in elderly patients with intertrochanteric fractures:a systematic review and meta-analysis[J].Surg Innov,2011,18(2):99-105.
[13] 樊政炎,彭昊,陳森,等.股骨近端防旋轉(zhuǎn)髓內(nèi)釘治療老年股骨粗隆間骨折的療效分析[J].骨科,2014,5(3):147-150.
[14] Patterson SM,Hughes CM,Cardwell C,et al.A cluster randomized controlled trial of an adapted U.S. model of pharmaceutical care for nursing home residents in Northern Ireland(Fleetwood Northern Ireland study):a cost-effectiveness analysis[J].J Am Geriatr Soc,2011,59(4):586-593.
[15] 徐偉,王志巖,師佩蘭,等.動力髖螺釘治療老年性股骨粗隆間骨折的療效分析[J].中華全科醫(yī)學(xué),2014,12(7):1044-1046.
[16] Van Ness PH,Peduzzi PN,Quagliarello VJ.Efficacy and effectiveness as aspects of cluster randomized trials with nursing home residents: Methodological insights from a pneumonia prevention trial[J].Contemp Clin Trials,2012,33(6):1124-1131.
[17] 浦津,劉衛(wèi)華.三種內(nèi)固定方法治療股骨粗隆間骨折療效分析[J].中國矯形外科雜志,2010,13(13):1081-1084.
[18] Danesh A,Janghorbani M,Khalatbari S.Effects of antenatal corticosteroids on maternal serum indicators of infection in women at risk for preterm delivery:A randomized trial comparing betamethasone and dexamethasone[J].J Res Med Sci,2012,17(10):911-917.
[19] 尹東,鄭秋堅,劉斌,等.DHS、PFN與FHR治療股骨粗隆間骨折的臨床比較[J].中國骨與關(guān)節(jié)損傷雜志,2010,25(4):298-301.
[20] Li YQ,Jin M,Qiu SL,et al.Effect of Chinese drugs for supplementing Qi,nourishing Yin and activating blood circulation on myocardial perfusion in patients with acute myocardial infarction after revascularization[J].Chin J Integr Med,2009,15(1):19-25.
[21] 王韶進,劉勝厚,劉文廣,等.骨水泥型長短柄假體置換治療高齡粉碎性轉(zhuǎn)子間骨折的三維有限元對比分析[J].中華骨科雜志,2010,30(11):1144-1150.
[22] Shao CP,Wang BY,Ye SH,et al.DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness[J].J Zhejiang Univ Sci B,2012,13(11):913-918.
[23] 侯永洋,龐施義,莊志杰,等.影響股骨粗隆間骨折術(shù)后療效的相關(guān)因素分析[J].中國骨與關(guān)節(jié)損傷雜志,2011,26(12):1061-1063.
[24] Magnus MC,Vestrheim DF,Nystad W,et al.Decline in early childhood respiratory tract infections in the norwegian mother and child cohort study after introduction of pneumococcal conjugate vaccination[J].Pediatric Infect Dis J,2012,31(9):951-955.
[25] Zhang P,Li C,Li Y,et al.Proteomic identification of differentially expressed proteins in sea cucumber Apostichopus japonicus coelomocytes after Vibrio splendidus infection[J].Dev Comp Immunol,2014,44(2):370-377.
[26] 顧春生,崇漢卿.股骨粗隆間骨折不同內(nèi)固定術(shù)式的療效分析[J].中國骨與關(guān)節(jié)損傷雜志,2011,26(12):1107-1108.

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備注/Memo

備注/Memo:
2014-12-19收稿 2015-01-20修回
更新日期/Last Update: 2015-04-30