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股骨近端仿生髓内钉与InterTAN髓内钉治疗老年股骨粗隆间骨折的疗效比较

Proximal femoral bionic intramedullary nail versus InterTAN intramedullary nail in the treatment of intertrochanteric femoral fractures in elderly patients

    摘要
  • 摘要:
    目的 比较股骨近端仿生髓内钉(PFBN)与InterTAN髓内钉治疗老年股骨粗隆间骨折的疗效。
    方法 回顾性分析45例老年股骨粗隆间骨折患者的临床资料，根据内固定方式不同分为PFBN组(25例)和InterTAN组(20例)。记录2组患者手术时间、术中出血量、术中透视次数、住院时间、Francisco评分优良率、骨折愈合时间、术后6个月随访时髋关节功能Harris评分、手术前后颈干角及术后并发症情况。
    结果 2组患者均获有效随访6~18个月，平均(10.53±2.17)个月。PFBN组手术时间、术中出血量、术中透视次数及住院时间与InterTAN组比较，差异无统计学意义(P>0.05)。PFBN组与InterTAN组Francisco评分优良率、6个月Harris评分及术后初次颈干角比较，差异均无统计学意义(P>0.05)。PFBN组骨折愈合时间短于InterTAN组，术后6个月颈干角大于InterTAN组，差异有统计学意义(P < 0.05)。
    结论 PFBN与InterTAN髓内钉治疗老年股骨粗隆间骨折均可获得较为满意的临床疗效，但与InterTAN髓内钉比较, PFBN在骨折愈合时间以及预防髋关节内翻畸形方面具有优势，适用于合并小粗隆骨折、严重骨质疏松及体质量较大的患者。

     

    Abstract:
    Objective To compare the efficacy of proximal femoral bionic intramedullary nail (PFBN) and InterTAN intramedullary nail in the treatment of elderly intertrochanteric femoral fractures.
    Methods The clinical data of 45 elderly patients with intertrochanteric fracture of femur were retrospectively analyzed. They were divided into PFBN group (25 cases) and InterTAN group(20 cases)according to the internal fixation methods. The operative time, intraoperative blood loss, intraoperative fluoroscopy times, length of hospital stay, excellent and good rate of Francisco score, fracture healing time, Harris score of hip function at 6 months postoperative follow-up, cervical trunk angle before and after surgery, and postoperative complications were recorded in the two groups.
    Results Patients in both groups were effectively followed up for 6 to 18 months, with an average of (10.53±2.17) months. There were no significant differences in operation time, intraoperative blood loss, intraoperative fluoroscopy times and hospital stay between PFBN group and InterTAN group (P>0.05). There were no significant differences in Francisco score, Harris score (6 months) and postoperative cervical trunk angle between PFBN group and InterTAN group (P>0.05). The fracture healing time in the PFBN group was significantly shorter than that in InterTAN group, and the postoperative cervical trunk angle at 6 months was significantly greater than that in the InterTAN group(P < 0.05).
    Conclusion Both PFBN and InterTAN intramedullary nail can achieve satisfactory clinical efficacy in the treatment of elderly intertrochanteric fractures of femur. However, compared with InterTAN intramedullary nail, PFBN has advantages in fracture healing time and prevention of hip various deformity, and is suitable for patients with minor trochanteric fractures, severe osteoporosis, and heavier body weight.

     

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