PCCP与PFNA对老年股骨粗隆间骨折患者手术创伤、术后功能恢复、内固定效果及并发症的影响(1)
【摘要】 目的：探討PCCP与PFNA内固定治疗老年稳定性股骨粗隆间骨折的临床效果。方法：选取2014年1月-2017年1月本院收治的老年股骨粗隆间骨折患者172例。按照治疗方法不同将其分为PCCP组96例和PFNA组76例。比较两组手术时间、术中出血量、血红蛋白下降量、骨折愈合时间、下地负重时间及并发症；比较两组术后4周股骨头旋转率、固定钉滑脱量及术后6个月的Harris评分。结果：PFNA组术中出血量、术后血红蛋白下降量均高于PCCP组，比较差异均有统计学意义(P<0.05)；PFNA组骨折愈合及下地负重时间均短于PCCP组，但比较差异均有统计学意义(P<0.05)；术后4周，PCCP组股骨头旋转率及固定钉滑脱量均高于PFNA组，比较差异均有统计学意义(P<0.05)；PCCP组并发症发生率为10.42%，低于PFNA组的15.79%，但比较差异无统计学意义(P>0.05)；术后6个月，两组Harris总分比较差异无统计学意义(P>0.05)；但PFNA组步态评分优于PCCP组(P<0.05)。结论：PCCP和PFNA内固定治疗老年稳定型股骨粗隆间骨折均有效，但采用PFNA治疗的患者固定钉滑脱量和股骨头旋转率均显著低于PCCP，且PFNA干预可以有效改善患者步态。
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【关键词】 PCCP； PFNA； 股骨粗隆间骨折； 功能恢复； 股骨头旋转； 固定钉滑脱
Effects of PCCP and PFNA on Surgical Trauma，Postoperative Functional Recovery，Internal Fixation and Complications in Elderly Patients with Intertrochanteric Fractures/LEI Zhixiong，CHENG Liangcai，CHEN Tiefeng，et al.//Medical Innovation of China，2018，15(14)：020-024
【Abstract】 Objective：To investigate the clinical efficacy of PCCP and PFNA internal fixation in the treatment of stable intertrochanteric fractures in the elderly.Method：A total of 172 elderly patients with intertrochanteric fractures from January 2014 to January 2017 in our hospital were selected.According to different treatment methods， they were divided into PCCP group(n=96) and PFNA group(n=76).The operation time，intraoperative blood loss，hemoglobin decline，fracture healing time，weight bearing time and complications between two groups were compared，the rotation rate of femoral head，fixation screw detachment after operation 4 weeks and Harris score after operation 6 months between two groups were compared.Result：The intraoperative blood loss and hemoglobin decline in PFNA group were higher than those of PCCP group，the differences were statistically significant(P<0.05).The fracture healing time and weight bearing time in PFNA group were shorter than those of PCCP group，the differences were statistically significant(P<0.05).After operation 4 weeks，the rotation rate of femoral head and fixation screw detachment in PCCP group were higher than those of PFNA group，the differences were statistically significant(P<0.05).The incidence of complications in PCCP group was 10.42%，which was lower than 15.79% in PFNA group，the difference was not statistically significant(P>0.05).After operation 6 months，the total score of Harris in two groups was compared，the difference was not statistically significant(P>0.05)，but the gait score of PFNA group was better than that of PCCP group(P<0.05).Conclusion：PCCP and PFNA internal fixation are effective in the treatment of stable femoral intertrochanteric fractures in the elderly， but the rotation rate of femoral head and fixation screw detachment in patients treated with PFNA were significantly lower than that of PCCP，and PFNA intervention could effectively improve the gait of the patients., http://www.100md.com(雷志雄 程良才 陈铁锋)
, http://www.100md.com
【关键词】 PCCP； PFNA； 股骨粗隆间骨折； 功能恢复； 股骨头旋转； 固定钉滑脱
Effects of PCCP and PFNA on Surgical Trauma，Postoperative Functional Recovery，Internal Fixation and Complications in Elderly Patients with Intertrochanteric Fractures/LEI Zhixiong，CHENG Liangcai，CHEN Tiefeng，et al.//Medical Innovation of China，2018，15(14)：020-024
【Abstract】 Objective：To investigate the clinical efficacy of PCCP and PFNA internal fixation in the treatment of stable intertrochanteric fractures in the elderly.Method：A total of 172 elderly patients with intertrochanteric fractures from January 2014 to January 2017 in our hospital were selected.According to different treatment methods， they were divided into PCCP group(n=96) and PFNA group(n=76).The operation time，intraoperative blood loss，hemoglobin decline，fracture healing time，weight bearing time and complications between two groups were compared，the rotation rate of femoral head，fixation screw detachment after operation 4 weeks and Harris score after operation 6 months between two groups were compared.Result：The intraoperative blood loss and hemoglobin decline in PFNA group were higher than those of PCCP group，the differences were statistically significant(P<0.05).The fracture healing time and weight bearing time in PFNA group were shorter than those of PCCP group，the differences were statistically significant(P<0.05).After operation 4 weeks，the rotation rate of femoral head and fixation screw detachment in PCCP group were higher than those of PFNA group，the differences were statistically significant(P<0.05).The incidence of complications in PCCP group was 10.42%，which was lower than 15.79% in PFNA group，the difference was not statistically significant(P>0.05).After operation 6 months，the total score of Harris in two groups was compared，the difference was not statistically significant(P>0.05)，but the gait score of PFNA group was better than that of PCCP group(P<0.05).Conclusion：PCCP and PFNA internal fixation are effective in the treatment of stable femoral intertrochanteric fractures in the elderly， but the rotation rate of femoral head and fixation screw detachment in patients treated with PFNA were significantly lower than that of PCCP，and PFNA intervention could effectively improve the gait of the patients., http://www.100md.com(雷志雄 程良才 陈铁锋)