目的：比较防旋股骨近端髓内钉（PFNA）与股骨近端锁定钢板（LPFP）治疗老年股骨粗隆间骨折的疗效。方法老年人股骨粗隆间骨折42例，行PFNA治疗23例（骨折按Evans分型Ⅱ型7例、Ⅲ型9例、Ⅳ型7例），行LPEP治疗19例（Evans分型Ⅰ型3例、Ⅱ型8例、Ⅲ型3例、Ⅳ型5例）。术后1个月、3个月、6个月X线复查。结果参照Harris髋关节功能评分标准，PFNA组优良率95.6％，LPEP组优良率94.7％，差异无统计学意义。结论 LPFP系统与PFNA系统治疗老年股骨粗隆间骨折均能取得较好的疗效，但从力学角度分析，由于髓内钉系统力臂短，固定更为稳固。%Objective Analyzed anti spin proximal femoral intramedullary nail(proximal femoral nail antirotation, PFNA),proximal femoral locking plate(LPFP)the curative effect of treatment of intertrochanteric fracture. Methods Our hospital from December 2007 to January 2009 a total of stuffs in the trochanteric fractures 42 cases,men and women,27 cases,in 15 cases. Age 62-90-year-old,an average of 72.8 years old. Fracture classification by Evans,PFNA 23 cases:the treatment 8 cases of type II,type III 9 cases,type Ⅳ 7 cases;LPEP 19 cases:the treatment of 3 cases of typeⅠ,8 cases of type II,type III 3 cases,Ⅳ5 cases. Postoperative follow-up and after 1 month,3 months,6 months x-ray review. Results Reference Harris hip scoring criteria,PFNA group patients rate of95.6%;LPEP group rate of 94.7%. Two sets of data to u(u=2.045,P>0.05),PFNA group curative effect of treatment of intertrochanteric fracture with LPEP group there was no statistically significant differences. Conclusion Through observation,intramedullary nail system(PFNA)and proximal femur anatomic locking plate screw system(LPFP)treatment of intertrochanteric fracture can obtain good effect.
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