关键词: 股骨转子间骨折, PFN钉内固定, 人工股骨头置换, 疗效

Abstract:

BACKGROUND: Proximal femoral nail (PFN) internal fixation has been widely used for the treatment of intertrochanteric fractures in senile patients and has a good therapeutic effect. However, it is still controversial that whether artificial joint replacement can be used in intertrochanteric fractures in senile patients.
OBJECTIVE: To investigate the clinical effect of PFN internal fixation versus hemiarthroplasty in intertrochanteric fractures of senile patients.
METHODS: Sixty-two senile patients with intertrochanteric fractures were selected from Department of Orthopedics at Tibetan Medicine Hospital, the age of patients was from 75 years old to 87 years old. All patients were randomly divided into PFN groups (PFNG) and hemiarthroplasty groups (HEMG), and received operative treatment with common operative route. Operative time, bloodless volume, function of hip joint and complication were compared between PFNG and HEMG groups.
RESULTS AND CONCLUSION: All operations of open reduction and internal fixation to intertrochanteric fractures in 62 cases of patients succeeded. ①Operative time was not remarkably different between PFNG and HEMG (P > 0.05). ②Bleeding volume, blood transfusion volume and time of getting out of bed was different (P < 0.05), which showed that operation wound was bigger in HEMG, but time of postoperative recovery was preponderant to PFNG. ③Incidence rate of medical complications and deformities of the hip joint was different between PFNG and HEMG, which showed that HEMG was preponderant to PFNG in preventing postoperative medical complications and deformities of the hip joint. ④Harris score showed activity of hip joint in the near future in HEMG was preponderant to that in PFNG.