首页|HA与PFNA治疗高龄不稳定A2/A3型股骨粗隆间骨折患者的效果比较

HA与PFNA治疗高龄不稳定A2/A3型股骨粗隆间骨折患者的效果比较

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目的:比较髋关节置换术(HA)与股骨近端防旋髓内钉(PFNA)内固定对高龄不稳定A2/A3 型股骨粗隆间骨折患者的影响.方法:回顾性分析 2016 年 1 月—2023 年 9 月新钢中心医院骨科收治114 例的高龄不稳定A2/A3 型股骨粗隆间骨折患者的临床资料.所有患者都经过手术治疗,根据手术方法分为HA组(n=12)与PFNA组(n=102).比较两组术中出血量、视觉模拟评分法(VAS)评分、髋关节功能及并发症发生情况.结果:HA组术中出血量高于PFNA组,差异有统计学意义(P<0.05).术后 7 d及 1、3、6 个月,两组Harris髋关节评分均逐步升高,HA组均高于PFNA组,差异均有统计学意义(P<0.05).术后,两组VAS评分均低于术前,且HA组低于PFNA组,差异有统计学意义(P<0.05).两组术后并发症总发生率比较,差异无统计学意义(P>0.05).结论:HA与PFNA内固定对于不稳定A2/A3 型高龄股骨粗隆间骨折患者均是行之有效的治疗方式,相较于PFNA内固定,HA术中出血量更多,但HA能更好地减轻术后疼痛,促进髋关节功能恢复,安全性较高.
Comparison of the Effect of HA and PFNA in the Treatment of Elderly Patients with Unstable A2/A3 Type Intertrochanteric Fracture of Femur
Objective:To compare the effects of hip arthroplasty(HA)and proximal femoral nail antirotation(PFNA)internal fixation in elderly patients with unstable A2/A3 type intertrochanteric fracture of femur.Method:The clinical data of 114 elderly patients with unstable A2/A3 type intertrochanteric fracture of femur admitted to the Department of Orthopedics of Xingang Central Hospital from January 2016 to September 2023 were retrospectively analyzed.All patients underwent surgery and divided into HA group(n=12)and PFNA group(n=102)according to surgical method.Intraoperative blood loss,visual analogue scale(VAS)score,hip joint function and complications were compared between the two groups.Result:The intraoperative blood loss in HA group was higher than that in PFNA group,the difference was statistically significant(P<0.05).At 7 d and 1,3 and 6 months after surgery,the Harris hip joint score in both group increased,those in HA group were higher than those in PFNA group,the differences were statistically significant(P<0.05).After surgery,VAS scores in both groups was lower than that before surgery,and that in HA group was lower than that in PFNA group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion:Both HA and PFNA internal fixation are effective treatment methods for elderly patients with unstable A2/A3 type intertrochanteric fracture of femur.Compared with PFNA internal fixation,HA has more intraoperative blood loss,but HA can better reduce postoperative pain and promote functional recovery of hip joint,with high safety.

Hip arthroplastyProximal femoral nail antirotation internal fixationIntertrochanteric fracture of femurPostoperative bleedingHip joint functionComplication

敖鹏、夏卫民、赵学辉

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新钢中心医院骨外科 江西 新余 338001

髋关节置换术 股骨近端防旋髓内钉内固定 股骨粗隆间骨折 术后出血 髋关节功能 并发症

江西省卫生健康委科技计划项目

202212246

2024

中国医学创新
中国保健协会

中国医学创新

影响因子:1.706
ISSN:1674-4985
年,卷(期):2024.21(22)