作　　者： (张宏）; (潘铄）; (冯涛）; (刘晓辉）; (康慧君）;

机构地区： 石家庄市第一医院骨一科,石家庄050031

出　　处： 《临床误诊误治》 2017年第8期90-93,共4页

摘　　要： 目的比较Inter Tan系统与PFNA-Ⅱ系统内固定治疗老年不稳定型股骨粗隆间骨折的效果及安全性。方法选择2009年8月—2014年10月石家庄市第一医院收治的应用Inter Tan系统或PFNA-Ⅱ系统内固定治疗的老年不稳定型股骨粗隆间骨折131例,将采用Inter Tan系统内固定治疗的58例作为Inter Tan组,采用PFNA-Ⅱ系统内固定治疗的73例作为PFNA-Ⅱ组。观察比较两组手术情况及随访情况,并对两组安全性进行评价。结果 Inter Tan组手术时间、X线透视时间及骨折愈合时间均长于PFNA-Ⅱ组,两组比较差异均有统计学意义(P<0.05)。术后各随访时间点髋关节功能Harris评分两组比较差异均无统计学意义(P>0.05)。Inter Tan组术中出现4例医源性股骨近端外侧壁骨折,而PFNA-Ⅱ组术中仅出现1例。PFNA-Ⅱ组3例因植入困难术中更换成短、细主钉,Inter Tan组无植入困难病例。结论老年不稳定型股骨粗隆间骨折应用Inter Tan系统与PFNA-Ⅱ系统内固定治疗均可取得良好效果,但PFNA-Ⅱ系统内固定治疗手术时间、X线透视时间、骨折愈合时间短,且并发症少,能够早期进行功能锻炼。 Objective To compare curative effect and safety between Inter Tan and PFNA-II system internal fixation in treatment of elderly patients with unstable fracture of femurs haft.Methods A total of 131 elderly patients with unstable fracture of femurs haft admitted during August 2009 and October 2014 were divided into Inter Tan group （n=58, treated with Inter Tan system internal fixation） and PFNA-II group （n=73, treated with PFNA-II system internal fixation）.In two groups, surgical conditions and follow-up data were compared, and conditions of surgical safety were evaluated.Results Surgical time, fluoroscopy time and fracture healed time were significantly longer in Inter Tan group than those in PFNA-II group （P〈0.05）.The differences in Harris scores for hip joint function at different times of follow-up were not statistically significant （P〉0.05）.In Inter Tan group, 4 patients had iatrogenic lateral proximal fractures during operation during surgery, while 1 patient had iatrogenic lateral proximal fractures during operation in PFNA-II group.In PFNA-II group, 3 patients were required a shorter and smaller nail during surgery because of the implantation difficulty, while none implantation difficulty was found in Inter Tan group.Conclusion Both Inter Tan and PFNA-II system internal fixation in treatment of elderly patients with unstable fracture of femurs haft can achieve good effect.PFNA-II system internal fixation can achieve short surgical time, fluoroscopy time and fracture healed time with less incidence of complication, and physical training at early stage.

关 键 词： 股骨骨折 老年人 骨折固定术 髓内 系统 系统