| 汪红林,许生领,魏龙雨,等.应用解剖型髓内钉与股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的效果对比[J].中国临床保健杂志,2021,24(3):382-386. |
| 应用解剖型髓内钉与股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的效果对比 |
| Comparison of two intramedullary nails in treatment of elderly intertrochanteric fracture:zimmer natural nail and proximal femoral nail antirotation |
| 投稿时间：2021-04-07 |
| DOI：10.3969/J.issn.1672-6790.2021.03.022 |
| 中文关键词: 股骨骨折 骨折固定术,髓内 骨钉 老年人 |
| 英文关键词: Femoral fractures Fracture fixation,intramedullary Bone nails Aged 〖FL |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨应用解剖型髓内钉(ZNN)与股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折的临床效果。方法 选取2016年10月至2019年10月合肥市第二人民医院骨科65例单侧股骨粗隆间骨折行髓内钉手术患者,其中ZNN组32例,PFNA组33例。对两组手术时间、术中出血量、骨折愈合时间,内固定物切出、感染、术后6个月和12个月随访时视觉模拟评分(VAS)以及髋关节Harris评分等进行统计学分析。结果 65例患者均获得6~18个月的随访。PFNA组手术时间和术中失血量低于ZNN组,且差异有统计学意义(P＜0.05)；两组骨折临床愈合时间、感染之间差异无统计学意义(P＞0.05)。术后6个月VAS疼痛评分、髋关节Harris评分中疼痛评分ZNN组优于PFNA组,两组差异有统计学意义(P＜0.05)；两组术后12个月VAS疼痛评分、髋关节Harris评分差异无统计学意义(P＞0.05)。结论 ZNN与PFNA髓内钉治疗股骨粗隆间骨折均可取得良好的临床治疗效果,ZNN术后髋部疼痛更轻,可优先考虑使用于股骨前弓明显增大的患者；PFNA手术时间短及术中出血量少,对于有基础疾病的患者应考虑优先使用。 |
| 英文摘要: |
| Objective To explore the clinical effect of ZNN(Zimmer natural nail) and PFNA(Proximal femoral nail antirotation) intramedullary nailing methods in the treatment of senile intertrochanteric fracture.Methods A total of 65 patients with unilateral intertrochanteric fracture of femur undergoing intramedullary nailed operation were enrolled from the department of orthopedics of the hefei second people's hospital from October 2016 to October 2019.Of 65 patients,32 were undergoing ZNN treatment and 33 were undergoing PFNA treatment.The operative time,intraoperative blood loss,fracture healing time,internal fixation removal and infection,and Visual Analogue Scale (VAS) pain scores and Harris hip scores at 6 months and 12 months were recorded and analyzed.Results The followed up time of all patients were 6 to 18 months.The operative time and intraoperative blood loss were lower in the PFNA group than those in the ZNN group (P＜0.05),but there were no significant differences in clinical healing time and infection between the two groups (P＞0.05).In addition,VAS score and pain score in Harris in the ZNN group were better than those in the PFNA group at 6 months (P＜0.05),but both VAS and Harris scores were no significant difference between the two groups at 12 months (P＞0.05).Conclusions ZNN and PFNA methods can achieve satisfactory clinical efficacy in the treatment of intertrochanteric fractures.The hip pain of ZNN group is lighter than PFNA group,while the operation time and blood loss are less in the PFNA group than those in the ZNN group,so the ZNN should be used priority for patients with significantly enlargement of the anterior femoral arch and the PFNA should be given priority for patients with underlying diseases. |
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