【摘要】：目的:這項(xiàng)研究的目的是對比分別接受PFNA與InterTan治療股骨轉(zhuǎn)子間骨折患者的臨床治療效果,從而比較兩種內(nèi)固定方式在轉(zhuǎn)子間骨折運(yùn)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(xué)第二醫(yī)院的股骨轉(zhuǎn)子間骨折患者,144例轉(zhuǎn)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(shù)后給予相同的治療及功能康復(fù)。通過對兩組患者的術(shù)中及術(shù)后臨床治療指標(biāo)的觀察,從而對比兩種治療方式的差異。術(shù)后定期隨訪,平均12.5個月。結(jié)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(jī)制及骨折類型方面差異無統(tǒng)計(jì)學(xué)意義;PFNA組和InterTan系統(tǒng)組手術(shù)時間(112.17±41.39和147.35±31.96)、術(shù)中出血量(177.54±74.49m L和250.79±50.45ml)、術(shù)后引流量(140.05±64.20和160.25±84.98),P0.05,差異有統(tǒng)計(jì)學(xué)意義;其他觀察指標(biāo)切口長度、術(shù)后髖關(guān)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(jù)無差異(P0.05),不具有統(tǒng)計(jì)學(xué)意義。應(yīng)用spss19.0軟件進(jìn)行分析。結(jié)論:PFNA與InterTan是2種有效治療股骨轉(zhuǎn)子間骨折的髓內(nèi)固定技術(shù)。InterTan系統(tǒng)具有更好的生物力學(xué)特性,固定穩(wěn)定性更強(qiáng)及抗旋轉(zhuǎn)更有效,使其對于那些復(fù)雜的外側(cè)大轉(zhuǎn)子骨折,近端股骨外側(cè)皮質(zhì)骨折及不穩(wěn)定股骨轉(zhuǎn)子間骨折的患者在固定穩(wěn)定及抗旋轉(zhuǎn)上具有優(yōu)勢。PFNA釘?shù)氖中g(shù)時間短,術(shù)中出血及術(shù)后引流少,操作相對簡單,骨量損失較少對老年骨質(zhì)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(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3

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