股骨近端锁定钢板对股骨转子骨折的疗效观察

王纯育 邓天伟

[摘要] 目的 观察股骨近端锁定钢板对股骨转子骨折的疗效。 方法 选取2016年1月～2018年10月在我院进行治疗的股骨转子间骨折患者54例为研究对象。根据手术方式分为股骨近端锁定钢板组29例和PFNA组25例，股骨近端锁定钢板组患者给予股骨近端锁定钢板治疗。PFNA组患者给予防旋近端髓内钉治疗。比较两组患者术前、术后4周、6个月髋关节功能情况，手术相关情况以及术后并发症发生情况。 结果 两组患者术前、术后4周、术后6个月Harris评分均无明显差异（P>0.05），股骨近端锁定钢板组患者与PFNA组相比，手术时间延长，但术中出血量减少，部分负重时间提前，差异有统计学意义（P<0.05），两组患者切口大小和住院时间比较，差异无统计学意义（P>0.05），两组患者术后并发症发生情况比较，差异无统计学意义（P>0.05）。 结论 股骨近端锁定钢板与PFNA对于股骨转子骨折均有较好的临床疗效，应根据患者具体情况选择术式。

[关键词] 股骨近端锁定钢板;防旋股骨近端髓内钉;股骨转子骨折

[中图分类号] R687.3          [文献标识码] B          [文章编号] 1673-9701（2019）24-0075-03

[Abstract] Objective To observe the therapeutic effect of proximal femoral locking plate on femoral intertrochanteric fracture. Methods A total of 54 patients with femoral intertrochanteric fractures who were treated in our hospital from January 2016 to October 2018 were selected as study subjects. According to the surgical methods， there were 29 cases in the proximal femoral locking plate group and 25 cases in the PFNA group. Patients in the proximal femoral locking plate group were treated with proximal femoral locking plate. Patients in the PFNA group were treated with anti-rotation proximal intramedullary nails. The hip joint function， surgery-related conditions and postoperative complications were compared between the two groups before surgery， 4 weeks after surgery and 6 months after surgery. Results There was no significant difference in Harris scores between the two groups before surgery， 4 weeks after surgery， and 6 months after surgery（P>0.05）. Compared with the PFNA group， the patients in the proximal femoral locking plate group had longer surgery time， but the intraoperative blood loss was reduced， and some weight-bearing time was advanced. The differences were statistically significant（P<0.05）. There was no statistically significant difference in the incision size and length of stay between the two groups of patients（P>0.05）. There was no statistically significant difference in postoperative complications between the two groups（P>0.05）. Conclusion The proximal femoral locking plate and PFNA have a favorable clinical effect on the femoral intertrochanteric fracture. The surgical procedure should be selected according to the patient's specific conditions.

[Key words] Proximal femoral locking plate; Proximal femoral nail; Femoral trochanter fracture

股骨转子骨折是临床常见的骨科外伤，多是由于交通事故、意外跌倒等外力因素所导致，中老年因为骨质疏松比较严重所以是高发人群，一旦发生如果不能得到及时有效的治疗，可能会影响患者的髋关节功能，而髋关节在人类下肢活动中具有重要的作用，因此有一定的致残率[1]。手术是治疗严重股骨转子骨折的主要手段，但临床研究发现不同术式的临床疗效不同[2]。股骨近端锁定钢板是治疗严重股骨转子骨折的重要术式之一，为观察该术式与防旋近端髓内钉（PFNA）在臨床中的应用效果，我院进行本次研究，为后续临床工作提供依据，现报道如下。