LPFP与PFN治疗不稳定性股骨粗隆间骨折的疗效分析

目的比较股骨近端锁定钢板(locking proximal femul plate,LPFP)与股骨近端带锁髓内钉(prox-imal femur nail,PFN)治疗不稳定性股骨粗隆间骨折的疗效。方法 82例不稳定性股骨粗隆间骨折患者,42例采用LPFP、40例PFN进行治疗。从切口长度、手术时间、术中出血量、术后引流量、骨折愈合时间、术后并发症、术后Harris髋关节评分方面进行分析比较。结果在切口长度、手术时间、术中出血量、术后引流量、术后并发症,LPFP组与PFN组比较差异有统计学意义(P<0.05)。LPFP组在切口长度、手术时间、术中出血量、术后引流量、术后并发症上高于PFN组。LPFP组较PFN组骨折愈合时间及髋关节功能比较差异无统计学意义(P>0.05)。结论在不稳定性股骨粗隆间骨折的治疗中,LPFP较PFN具有切口长、手术时间长、出血多、术后并发症多及术后并发症较高的缺点,在不稳定性股骨粗隆间骨折的治疗中应慎用,推荐PFN。但对于髓腔过小、股骨生理性前弓曲度过大的患者LPFP为首选。

Analysis of LPFP and PFN Operation on Unstable Intertrochanteric Fracture of Femur

Objective To compare the locking proximal femul plate（LPFP）and proximal femurnaill（PFN）in treatment of unstable intertrochanteric fracture of femur.Methods There were 82patients with unstable intertrochanteric fracture of femur,42 patients were treated with LPFP,40 pa-tients were treated with PFN. The incision length,operation time,intraoperative blood loss,postop-erative drainage,clinical healing time of fracture,post operative complications and the excellentand good rate in Harris score were recorded.Results There was significant difference between thetwo groups in the incision length,operation time,intraoperative blood loss,postoperative drainage, postoperative complication s（P〈0. 05）. The LPFP group incision length,operative time,intraoper-ative blood loss,postoperative drainage,post operative complications were higher than those of thePFN group.There was no significant difference between the two groups in the clinical healing time offracture and the excellent and good rate in Harris score（ P〉0. 05）.Conclusion In the treat-ment of unstable intertrochanteric fracture of the femur,the LPFP group has a longer incision,lon-ger operation time,more bleeding,more postoperative complications and higher postoperative com-plications than PFN group. In the treatment of unstable intertrochanteric fractures should be careful-ly used and here recommends the PFN. But for medullary cavity is too small,and patients with largerfemur anterior arch curve,LPFP is preferred.