The efficacy comparison of proximal femoral nail and proximal femoral locking plate in the treatment of the femoral intertrochanteric fractures
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摘要: 目的:比较股骨近端髓内钉(proximal femoral nail,PFN)与股骨近端锁定钢板(proximal femoral locking plate,PFLP)内固定治疗股骨转子间骨折的疗效。方法:将71例转子间骨折按内固定方法分为PFLP组32例和PFN组39例;按Evans分型分为稳定性骨折(EvansⅠ～Ⅱ型,31例)和不稳定性骨折(EvansⅢ～Ⅴ型,40例)。观察2组手术时间、术中出血量、骨折愈合时间、并发症及髋关节功能恢复情况。结果:病例均一期愈合,随访9～14个月,对于EvansⅠ～Ⅱ型股骨转子间骨折,2组术中失血量、骨折愈合时间和Harris评分差异均无统计学意义(0. 05);对于EvansⅢ～Ⅴ型股骨转子间骨折,术中失血量PFN组少于PFLP组(P0. 01)。结论:对于EvansⅠ～Ⅱ型骨折,PFN与PFLP比较无明显优势;对于EvansⅢ～Ⅴ型骨折,PFN更有优势。Abstract: Objective: To compare the clinical effects of proximal femoral nail( PFN) and proximal femoral locking plate( PFLP) in the treatment of the femoral intertrochanteric fractures. Methods: Seventy-one patients with femoral intertrochanteric fractures were divided into PFN group( 39 cases) and PFLP group( 32 cases) according to their different internal fixation Methods. According to Evans classification， there were 31 cases of type Ⅰ，Ⅱ fractures and 40 cases of type Ⅲ to Ⅴ fractures. The operative time，blood loss，bone healing time， complications and Harris Hip Score of two groups were compared. Results: All cases were primary healing， and followed up for 9 to 14 months. The differences of the blood loss，bone healing time and Harris Hip Score of patients with type Ⅰ，Ⅱ fractures in two groups were not statistical significance( P ＞ 0. 05) . The blood loss of patients with type Ⅲ to Ⅴ fractures in PFN group was significantly lower than that in PFLP group( P ＜ 0. 01) . Conclusions: The effects of PFN and PFLP in the treatment of type Ⅰ，Ⅱ fractures have no significant difference， the effect of PFN in the treatment of type Ⅲ to Ⅴ fractures are better than that of PFLP.
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