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《股骨近端防旋髓内钉与解剖型锁定钢板治疗老年不稳定型股骨转子间骨折疗效比较-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、·324·临床骨科杂志JournalofClinicalOrthopaedics2014Jun;17(3)doi:10.3969/j.issn.1008-0287.2014.03.033·临床论著·股骨近端防旋髓内钉与解剖型锁定钢板治疗老年不稳定型股骨转子间骨折疗效比较秦伟光,李忠华,张秀华,张鹏,高兆峰,王合强,王海林摘要:目的比较股骨近端防旋髓内钉(PFNA)与解剖型锁定钢板(ALP)治疗老年不稳定型股骨转子间骨折的临床疗效。方法选取92例老年不稳定型股骨转子间骨折的患者,按随机数法分为PFNA组
2、(46例)和ALP组(46例),分别采用PFNA内固定与ALP内固定。对比分析两组患者术中一般情况、术后恢复情况及并发症的发生情况。结果手术时间、术中出血及术后引流量PFNA组均明显少于ALP组(t=20.099、3.111、2.864,P=0.000、0.003、0.005)。92例均获随访,时间4~7个月。骨折愈合时间及术后髋关节功能评分两组比较差异均无统计学意义(t=0.499、0.674,P=0.619、0.502)。并发症发生率两组比较差异无统计学意义(2.2%4.3%,x=0.345,P=
3、0.557)。结论PFNA与ALP在老年不稳定型股骨转子间骨折治疗中的临床疗效相当,但PFNA所造成的损伤较小,更有利于术后患者的恢复。关键词:不稳定型股骨转子间骨折;股骨近端防旋髓内钉;解剖锁定型钢板中图分类号:R683.42;R687.3文献标识码:A文章编号:1008—0287(2014)03—0324—04Comparisonofproximalfemoralnailantirotationandanatomicallockingcompressionplateinthetreatmentof
4、elderpatientswithunstableintertrochantericfracturesQ/N—guang.LIZhong—hua,ZⅣGXiu-hua,ZHANGPeng,GAOZhaong,WANGHe—Qiang,ⅣG一(Sec—tion1I,DeptofOrthopaedics,£PeoplesHospitalofZhanhuaCounty,Zhanhua,Shandong256800,China)Abstract:ObjectiveTocomparetheeffectofpro
5、ximalfemoralnailantirotation(PFNA)andanatomicallockingcompressionplate(AIJP)inthetreatmentofelderpatientswithunstableintertrochantericfracture.Methods92pa-tientswithunstableintertrochantericfracturewererandomlydividedintothePFNAgroupandtheALPgroup.There
6、were46patientsineachgroup.Comparedwithgeneralsituationduringthesurgery,postoperativerecoveryandcom—plicationsbetweenthetwogroups.ResultsOperativetimebloodlossandpostoperativedrainagevolumeofthePF·,NAgroupwassignificantlylessthanthatoftheAIgroup(t=20.099
7、,3.111,2.864,P=0.000,0.003,0.005).Allpatientswerefollowedupfor4~7monthsthediferenceoffracturehealingtime,postoperativehipscoreandrateof,occurrenceofcomplicationswerenotstatisticalysignificant(t=0.499,0.674,P=0.619,0.502).Thedifferencebetweenthetwogroups
8、inincidenceofpostoperativecomplicationswasnotstatisticallysignificant(2.2%4.3%,x=0.345,P=0.557).ConclusionsTheeffectofPFNAandALPintreatingeiderpatientswithunstableintertro.chanteriefractureissimilar,butPFNAcauseslessdamage,whichi
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