發(fā)布時間：2018-08-04 11:36

【摘要】：目的:這項研究的目的是對比分別接受PFNA與InterTan治療股骨轉子間骨折患者的臨床治療效果,從而比較兩種內固定方式在轉子間骨折運用中的優(yōu)劣性。方法:收集自2014年5月1日至2016年5月31日就診于山西醫(yī)科大學第二醫(yī)院的股骨轉子間骨折患者,144例轉子間骨折患者入選本研究,其中92例患者采用PFNA治療,52例患者采用InterTan治療,兩組患者術后給予相同的治療及功能康復。通過對兩組患者的術中及術后臨床治療指標的觀察,從而對比兩種治療方式的差異。術后定期隨訪,平均12.5個月。結果:在兩個組之間觀察到,PFNA組和InterTan組在患者性別、年齡、受傷機制及骨折類型方面差異無統(tǒng)計學意義;PFNA組和InterTan系統(tǒng)組手術時間(112.17±41.39和147.35±31.96)、術中出血量(177.54±74.49m L和250.79±50.45ml)、術后引流量(140.05±64.20和160.25±84.98),P0.05,差異有統(tǒng)計學意義;其他觀察指標切口長度、術后髖關節(jié)功能Harris評分、骨折愈合時間的比較,可以得出兩組數(shù)據無差異(P0.05),不具有統(tǒng)計學意義。應用spss19.0軟件進行分析。結論:PFNA與InterTan是2種有效治療股骨轉子間骨折的髓內固定技術。InterTan系統(tǒng)具有更好的生物力學特性,固定穩(wěn)定性更強及抗旋轉更有效,使其對于那些復雜的外側大轉子骨折,近端股骨外側皮質骨折及不穩(wěn)定股骨轉子間骨折的患者在固定穩(wěn)定及抗旋轉上具有優(yōu)勢。PFNA釘?shù)氖中g時間短,術中出血及術后引流少,操作相對簡單,骨量損失較少對老年骨質疏松患者,可能是一種較好的選擇。
[Abstract]:Objective: to compare the clinical efficacy of PFNA and InterTan in the treatment of intertrochanteric fracture of femur, and to compare the advantages and disadvantages of the two internal fixation methods in the treatment of intertrochanteric fracture. Methods: a total of 144 patients with intertrochanteric fracture of femur who were admitted to the second Hospital of Shanxi Medical University from May 1, 2014 to May 31, 2016 were enrolled in this study. Among them, 92 cases were treated with PFNA and 52 cases were treated with InterTan. The two groups were given the same treatment and functional rehabilitation after operation. By observing the clinical treatment indexes of the two groups during and after operation, the differences between the two treatment methods were compared. The average follow-up was 12.5 months. Results: between the two groups, the sex, age and age of the patients were observed in the InterTan group and the PFNA group. There was no significant difference in injury mechanism and fracture type between PFNA group and InterTan system group (112.17 鹵41.39 and 147.35 鹵31.96), intraoperative bleeding volume (177.54 鹵74.49 mL and 250.79 鹵50.45ml) and postoperative drainage volume (140.05 鹵64.20 and 160.25 鹵84.98) were significantly different (P 0.05). Postoperative hip function Harris score, fracture healing time comparison, we can get two groups of data have no difference (P0.05), there is no statistical significance. Spss19.0 software is used to analyze. Conclusion two effective intramedullary fixation techniques, I. E. InterTan system, for the treatment of intertrochanteric fractures of femur, have better biomechanical properties, stronger fixation stability and more effective anti-rotation, making them more effective in the treatment of complex lateral greater trochanteric fractures. The patients with proximal femoral lateral cortical fracture and unstable intertrochanteric fracture had advantages in fixation stability and anti-rotation. The operation time of PFNA nail was short, the operative bleeding and postoperative drainage were less, and the operation was relatively simple. Less bone loss may be a better choice for elderly patients with osteoporosis.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

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