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1、PFNA、股骨头置换及锁定钢板治疗老年股骨转子间骨折的临床疗效分析摘要:目的比较股骨近端防旋髓内钉(PFNA)、股骨头置换(FI1R)和解剖型锁定钢板(ALP)三种手术方法治疗效果。方法对我院2011年3月〜2014年12月收治的113例分别接受PFNA、FHR和ALP的患者进行回顾性分析。其中,PFNA组39例,ALP组37例,FHR组37例。对三组患者的术中情况、术后并发症及Harris髓关节功能等资料进行回顾性研究。结果113例全部获得随访,随访时间8?19个月,平均12.7个月。平均手术时间三组间比较,F值为49.43,差异有统计学意义(P0.05);术后部分负重时间:AL
2、P组〉PFNA组〉FHR组,两两比较有统计学差异(P0.05)。术后1、6个月Harris评分有统计学意义(P>0.05),而术后12个月无统计学差异(P>0.05)。结论PFNA、FHR和ALP均可获得较满意疗效,其中PIHA组具冇创伤小、固定可靠、术后并发症少等优点,可作为临床首选治疗方案。关键词:老年;转子间骨折;PFNA;股骨头置换;解剖锁定钢板AnalysisofClinicalEfficacyofPFNA,FemoralHeadReplacementandLockingPlateintheTreatmentofElderlyFemoralIntertrochanteri
3、cFracturesZHUXiang-dong,WANGGang,QIANLi-biao,XUZi-shcng(AnqingPetrochemicalHospital,NanjingGulouHospitalGroup,Nanjing210000,Jiangsu,China)Abstract:ObjectiveTocomparetheeffectsofthreesurgicalmethodsofproximalfemoralnailantirotation(PFNA),femoralheadreplacement(FHR)andanatomicallockingplate(ALP)
4、・MethodsAretrospectiveanalysiswasperformedon113patientswithPFNA,FHRandALPadmittedtoourhospitalfromMarch2011toDecember2014.Amongthem,PFNAgroupof39cases,ALPgroupof37cases,FHRgroupof37cases・Dataof3groupsofpatientsintheintraoperative,postoperativecomplicationsandHarrishipfunctionwereretrospectivel
5、ystudied.ResultsAll113caseswerefollowedup,followuptimefrom8to19months,anaverageof12.7months.Theaverageoperationtimewascomparedbetweenthethreegroups,thevalueofFfor49.43,thedifferencewasstatisticallysignificant(P0.05);postoperativeweight-bearingtime:ALPgroup>PFNAgroup>FHRgroup,pairwisecomparison
6、withstatisticallysignificantdifference(P0.05)・After1and6months,Harrisscorewasstatisticallysignificant(P>0.05),andnosignificantdifferencwasnotstatisticallysignificant(P>0.05)・ConclusionPFNA,FHRandALPcanobtainsatisfactorycurativeeffect,thePFNAgrouphastheadvantagesoflesstrauma,reliablefixation,le
7、sscomplicationsandsoon.Itcanbeusedasthepreferredclinicaltreatmentplan.Keywords:Elderly;Intertrochantericfractures;PFNA;Femoralheadreplacement;Anatomicallockingplate?s着生活水平提高,人口老龄化及生活方式改变,股骨转子间骨折发生率日益增加。非手术治疗需长期卧床,并发症较多,病死率为15%〜20%。冃前主张手