Abstract：Objective: To investigate and compare the efficacy of PFNA internal fixation and arthroplasty in treatment of unstable intertrochanteric fractures in elderly patients. Methods: A total of 150 patients with unstable intertrochanteric fractures admitted from October 2013 to October 2016 were randomly divided into two groups. The patients in the internal fixation group received PFNA internal fixation. The patients in the joint replacement group were treated with arthroplasty. Perioperative clinical indexes, complications, recovery of joint function and long-term quality of life of the two groups before and after treatment. Results: The operation time, intraoperative blood loss, postoperative drainage, postoperative weight-bearing time and fracture healing time were significantly lower in the patients in the internal fixation group than those in the joint replacement group. The quality of life scores in each dimension were significantly different There was significant difference between the two groups (P <0.01). The overall complication rate was significantly lower than that of the control group. The rate of joint function was significantly higher than that of the joint replacement group (P <0.05). Conclusion: Compared with the arthroplasty, the clinical efficacy of PFNA internal fixation in patients with unstable intertrochanteric fractures is more significant and has reference value.
李坤, 张育民, 郭建斌, 王亚康. PFNA内固定与关节置换治疗高龄不稳定型转子间骨折的疗效对比[J]. 河北医学, 2018, 24(1): 55-58.
LI Kun, ZHANG Yumin, GUO Jianbin, et al. Comparison of PFNA Internal Fixation and Arthroplasty in the Treatment of Unstable Intervertebral Fractures in Elderly Patients. HeBei Med, 2018, 24(1): 55-58.
[1] 白志刚,宋强,程锁利,等.四种手术方式治疗高龄骨质疏松性股骨转子间骨折的回顾性分析[J].中国骨质疏松杂志,2017,23(6):790~794. [2] 张庆猛,李明,刘培来,等.人工关节置换和PFNA内固定治疗老年人股骨转子间骨折的疗效比较[J].山东医药,2013,53(1):69~71. [3] 张大鹏,侯明明,张圣洁.老年股骨转子间骨折行股骨近端髓内钉内固定术与人工髋关节置换术的疗效对比[J].山西医科大学学报,2014,45(11):1100~1101. [4] 郑小龙,魏建仝,王勇平,等.髋关节置换与股骨近端髓内钉比较治疗我国老年转子间骨折效果的Meta分析[J].中华临床医师杂志(电子版),2016,10(1):82~88. [5] Liu J J,Shan L C,Deng B Y,et al.Reason and treatment of failure of proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures of senile patients[J].Genet moL Res,2014,13(3):5949~5956. [6] 吴强.骨水泥半髋关节置换与PFNA固定治疗高龄股骨转子间骨折疗效对比[J].医学信息,2016,29(18):176~177. [7] Jia L,Zhang K,Wang Z G,et al.Proximal femoral nail antirotation internal fixation in treating intertrochanteric femoral fractures of elderly subjects[J].Biol Regul Homeost Agents,2017,31(2):329~334. [8] 卫江华,许刚.股骨距替代型髋关节置换术与PFNA固定术治疗高龄不稳定型股骨转子间骨折的临床疗效比较[J].中国药物与临床,2015,15(9):1346~1348. [9] 郝兴哲.股骨近端防旋髓内针与人工关节置换治疗老年股骨转子间骨折对比分析[J].创伤外科杂志,2016,18(3):162~165. [10] Dong J B,Wang Z Y,Lu H,et al.Meta-analysis of internal fixation versus hip replacement in the treatment of trochanteric fractures[J].Zhongguo Gu Shang,2015,28(3):245~251. [11] 蒋志刚,刘锋.股骨近端防旋髓内钉和半髋关节置换治疗老年不稳定型股骨转子间骨折的临床疗效[J].江苏医药,2016,42(18):1980~1982. [12] Tang S L,Jiang C.Comparison of the effect of inverted less invasive stabilization system(LISS)and proximal femoral nail anti-rotation(PFNA)in the treatment of complex unstable intertrochanteric fracture in aged[J].Zhongguo Gu Shang,2011,24(5):366~369. [13] 马春杰,郑爽,李干卿,等.不稳定性转子间骨折PFNA术后失效行THA或内固定翻修的疗效分析[J].创伤外科杂志,2017,19(9):691~694. [14] 张鹏,张春艳,李家伟.PFNA内固定和关节置换治疗高龄不稳定型转子间骨折的对比研究[J].西部医学,2017,29(8):1097~1100,1105. [15] Yang H,Zhou F,Tian Y,et al.Analysis of the failure reason of internal fixation in peritrochanteric fractures[J].Beijing Da Xue Xue Bao,2011,43(5):699~702. [16] 蒋健,赵德勇,王龙,等.PFNA与人工关节置换术治疗老年不稳定型转子间骨折的疗效[J].江苏医药,2017,43(18):1321~1324.
2018, Vol. 24 
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