王純育 鄧天偉

[摘要] 目的 觀察股骨近端鎖定鋼板對股骨轉子骨折的療效。 方法 選取2016年1月～2018年10月在我院進行治療的股骨轉子間骨折患者54例為研究對象。根據手術方式分為股骨近端鎖定鋼板組29例和PFNA組25例，股骨近端鎖定鋼板組患者給予股骨近端鎖定鋼板治療。PFNA組患者給予防旋近端髓內釘治療。比較兩組患者術前、術后4周、6個月髖關節功能情況，手術相關情況以及術后并發癥發生情況。 結果 兩組患者術前、術后4周、術后6個月Harris評分均無明顯差異（P>0.05），股骨近端鎖定鋼板組患者與PFNA組相比，手術時間延長，但術中出血量減少，部分負重時間提前，差異有統計學意義（P<0.05），兩組患者切口大小和住院時間比較，差異無統計學意義（P>0.05），兩組患者術后并發癥發生情況比較，差異無統計學意義（P>0.05）。 結論 股骨近端鎖定鋼板與PFNA對于股骨轉子骨折均有較好的臨床療效，應根據患者具體情況選擇術式。

[關鍵詞] 股骨近端鎖定鋼板;防旋股骨近端髓內釘;股骨轉子骨折

[中圖分類號] R687.3 ? ? ? ? ?[文獻標識碼] B ? ? ? ? ?[文章編號] 1673-9701（2019）24-0075-03

[Abstract] Objective To observe the therapeutic effect of proximal femoral locking plate on femoral intertrochanteric fracture. Methods A total of 54 patients with femoral intertrochanteric fractures who were treated in our hospital from January 2016 to October 2018 were selected as study subjects. According to the surgical methods， there were 29 cases in the proximal femoral locking plate group and 25 cases in the PFNA group. Patients in the proximal femoral locking plate group were treated with proximal femoral locking plate. Patients in the PFNA group were treated with anti-rotation proximal intramedullary nails. The hip joint function， surgery-related conditions and postoperative complications were compared between the two groups before surgery， 4 weeks after surgery and 6 months after surgery. Results There was no significant difference in Harris scores between the two groups before surgery， 4 weeks after surgery， and 6 months after surgery（P>0.05）. Compared with the PFNA group， the patients in the proximal femoral locking plate group had longer surgery time， but the intraoperative blood loss was reduced， and some weight-bearing time was advanced. The differences were statistically significant（P<0.05）. There was no statistically significant difference in the incision size and length of stay between the two groups of patients（P>0.05）. There was no statistically significant difference in postoperative complications between the two groups（P>0.05）. Conclusion The proximal femoral locking plate and PFNA have a favorable clinical effect on the femoral intertrochanteric fracture. The surgical procedure should be selected according to the patient's specific conditions.

[Key words] Proximal femoral locking plate; Proximal femoral nail; Femoral trochanter fracture

股骨轉子骨折是臨床常見的骨科外傷，多是由于交通事故、意外跌倒等外力因素所導致，中老年因為骨質疏松比較嚴重所以是高發人群，一旦發生如果不能得到及時有效的治療，可能會影響患者的髖關節功能，而髖關節在人類下肢活動中具有重要的作用，因此有一定的致殘率[1]。手術是治療嚴重股骨轉子骨折的主要手段，但臨床研究發現不同術式的臨床療效不同[2]。股骨近端鎖定鋼板是治療嚴重股骨轉子骨折的重要術式之一，為觀察該術式與防旋近端髓內釘（PFNA）在臨床中的應用效果，我院進行本次研究，為后續臨床工作提供依據，現報道如下。