两种方法治疗股骨转子下骨折的疗效比较OA

Objective To compare the efficacy of femoral reconstruction intramedullary nail and proximal femoral locking plate in the treatment of subtrochanteric fracture of the femur.Methods Sixty-one patients with subtrochan-teric fractures of the femur were divided into the intramedullary nail group(treated with femoral reconstruction intr-amedullary nail,31 cases)and the plate group(treated with proximal femoral locking plate fixation,30 cases)ac-cording to different surgical methods.The surgical conditions,fracture reduction and healing,knee flexion range of motion and postoperative complications of the two groups were recorded,and the therapeutic effect was evaluated by the Harris scores of the hip function.Results All patients were followed up for 12-34 months.The operation time,intraoperative blood loss and incision length in the intramedullary nail group were all shorter(less)than those in the plate group(P＜0.01).The frequency of intraoperative fluoroscopy in the intramedullary nail group was more than that in the plate group(P＜0.01).There was no statistically significant difference in the quality of fracture reduction between the two groups(P＞0.05).The starting time of partial weight-bearing and fracture healing time in the intr-amedullary nail group were shorter than those in the plate group(P＜0.05).There were no statistically significant differences in the knee flexion range of motion,Harris score of the hip joint,and the incidence of postoperative com-plications between the two groups at the last follow-up(P＞0.05).Conclusions Both femoral reconstruction intr-amedullary nail and proximal femoral locking plate fixation can achieve satisfactory hip joint function in the treatment of subtrochanteric femoral fractures.However,intramedullary nail fixation has less surgical trauma,which can start weight-bearing functional exercise earlier,and has a shorter fracture healing time.