PFNA内固定术与InterTan髓内钉内固定术治疗老年股骨粗隆间骨折的效果对比OA
Comparison of the Effects of PFNA Internal Fixation and InterTan Intramedullary Nail Internal Fixation in the Treatment of Femoral Intertrochanteric Fracture in Elderly
目的:对比股骨近端防旋髓内钉(PFNA)内固定术与 InterTan 髓内钉内固定术治疗老年股骨粗隆间骨折的效果.方法:回顾性分析南京中医药大学附属南京市中西医结合医院 2020 年 1 月—2025 年 1 月 80 例老年股骨粗隆间骨折患者的临床资料,根据患者手术方案的差异分为观察组(n=40,PFNA 内固定术治疗)与对照组(n=40,InterTan 髓内钉内固定术治疗).比较两组围手术期指标及骨折愈合指标,评估两组手术前后髋关节功能、生活质量及日常生活能力.结果:观察组手术时间短于对照组,术中出血量少于对照组,术后首次负重时间晚于对照组,骨折愈合时间长于对照组(P<0.05);两组的术后并发症发生率比较,差异无统计学意义(P>0.05);术后 6 个月,两组 Harris 髋关节功能评分的各维度评分与总分比较,差异无统计学意义(P>0.05).术后 6 个月,两组生活质量综合评定问卷(GQOLI-74)评分和 ADL 评分比较,差异无统计学意义(P>0.05).结论:PFNA 内固定术与 InterTan 髓内钉内固定术治疗老年股骨粗隆间骨折患者术后的髋关节功能恢复效果、术后日常生活能力和生活质量的提升效果是相近的,但PFNA内固定术的手术时间更短,术中出血量更少.
Objective:To compare the efficacy of proximal femural nail antirotation(PFNA)internal fixation and InterTan intramedullary nail internal fixation in the treatment of femoral intertrochanteric fracture in the elderly.Method:A retrospective analysis was conducted on the clinical data of 80 elderly patients with femoral intertrochanteric fracture in Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Affiliated to Nanjing University of Chinese Medicine from January 2020 to January 2025.According to the differences in surgical plans of the patients,they were divided into the observation group(n=40,treated with PFNA internal fixation)and the control group(n=40,treated with InterTan intramedullary nail internal fixation).The perioperative indicators and fracture healing indicators of the two groups were compared,and the hip joint function,quality of life and activities of daily living before and after the operation of the two groups were evaluated.Result:The operation time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that of the control group,the first weight-bearing time after surgery was later than that of the control group,and the fracture healing time was longer than that of the control group(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).At 6 months after the operation,there were no statistically significant differences in the scores of each dimension and the total score of Harris hip function score between the two groups(P>0.05).At 6 months after the operation,there were no statistically significant differences in the scores of the generic quality of life inventory(GQOLI-74)and ADL between the two groups(P>0.05).Conclusion:PFNA internal fixation and InterTan intramedullary nail internal fixation in the treatment of elderly patients with femoral intertrochanteric fracture have similar effects on hip joint function recovery,postoperative activities of daily living and quality of life,but PFNA internal fixation has shorter operation time and less intraoperative blood loss.
胡恩强;王慎;芮敏劼;嵇辉
南京中医药大学附属南京市中西医结合医院骨伤科 江苏 南京 210014南京中医药大学附属南京市中西医结合医院骨伤科 江苏 南京 210014南京中医药大学附属南京市中西医结合医院骨伤科 江苏 南京 210014南京中医药大学附属南京市中西医结合医院骨伤科 江苏 南京 210014
股骨粗隆间骨折股骨近端防旋髓内钉内固定术InterTan 髓内钉内固定术围手术期指标髋关节功能生活质量
Femoral intertrochanteric fractureProximal femural nail antirotation internal fixationInterTan intramedullary nail fixationPerioperative indicatorsHip joint functionQuality of life
《中国医学创新》 2026 (10)
10-14,5
2024年度南京中医药大学自然科学基金项目(XZR2024121)2024年度南京市卫生科技发展专项资金资助项目(YKK24203)2024年度江苏省中医药学会科研项目(CYTF2024023)第七批南京市名中医(宁卫中医[2022]7号)
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