| 柴 浩,续 斌.PFBN与InterTAN髓内钉内固定治疗老年不稳定型IFF效果对比[J].中国烧伤创疡杂志,2025,(4):311~313. |
| DOI： |
| 中文关键词: 老年 不稳定型股骨粗隆间骨折 股骨近端仿生髓内钉 ＩｎｔｅｒＴＡＮ 髓内钉 内固定 疗效 |
| 英文关键词:Elderly Unstable intertrochanteric femur fracture Proximal femoral bionic nail InterTAN intramedullary nail Internal fixation Clinical efficacy |
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| 中文摘要: |
| 【摘要】 目的 对比分析股骨近端仿生髓内钉(PFBN)与InterTAN髓内钉内固定治疗老年不稳定型股骨粗隆间骨折 (IFF) 的临床疗效。 方法 选取 2022 年 5 月至 2023年5月新疆医科大学第六附属医院收治的 96 例老年不稳定型 IFF 患者为研究对象, 根据不同手术方式将其分为 PFBN 组 ( 46 例) 和 InterTAN 组 ( 50 例), PFBN组患者采用 PFBN 内固定治疗, InterTAN 组患者采用 InterTAN 髓内钉内固定治疗, 对比观察两组患者手术、髋关节解剖结构与功能恢复、骨折复位及术后不良事件发生情况。结果 PFBN 组患者术中出血量与透视次数多于 InterTAN 组、手术时间长于InterTAN 组( t = 2.790、2.590、2.024, P = 0.006、0.011、0.046); 术后 1 年, PFBN 组患者颈干角 (FNSA) 大于 InterTAN 组、顶尖距 (TAD) 小于InterTAN组( t = 3.280、4.594, P = 0.002、P<0.001); 术后 1、3 个月, PFBN 组患者髋关节 Harris 评分均明显高于 InterTAN 组 (t= 12.066、4.607, P 均< 0.001); 术后1年, PFBN 组患者骨折复位质量与 InterTAN 组无明显差异 (Z= -0.300, P = 0.764)、且其间不良事件发生率与 InterTAN 组无明显差异 (χ2 = 1.169, P = 0.280)。结论 PFBN 内固定与 InterTAN 髓内钉内固定治疗的老年不稳定型 IFF 患者的远期髋关节功能恢复效果及骨折复位质量相当, 但与 InterTAN 髓内钉内固定相比, PFBN 内固定虽存在术中出血量及透视次数多、手术时间长等弊端, 却能够提高髋关节解剖结构及近期髋关节功能恢复效果。 |
| 英文摘要: |
| 【Abstract】 Objective To compare the clinical efficacy of proximal femur bionic nail (PFBN) and InterTAN intramedullary nailing fixation in the treatment of unstable intertrochanteric femur fractures (IFF) in the elderly. Methods 96 elderly patients with unstable IFF admitted to Sixth Affiliated Hospital of Xinjiang Medical University from May 2022 to May 2023 were enrolled as research subjects and divided into the PFBN group (n = 46) and the InterTAN group (n = 50) based on different surgical methods. Patients in the PFBN group were treated with PFBN internal fixation, while the InterTAN group were treated with InterTAN intramedullary nailing fixation. The surgical conditions, hip joint anatomical structure and function recovery, fracture reduction, and postoperative adverse reactions were compared between the two groups. Result The intraoperative blood loss and fluoroscopy time were more, the surgical duration of patients was longer in the PFBN group (t = 2.790, 2.590 and 2.024, P = 0.006, 0.011 and 0.046). One year after surgery, the femoral neck-shaft angle (FNSA) was larger and the tip-apex distance (TAD) was smaller in the PFBN group (t = 3.280 and 4.594, P= 0.002, P< 0.001). Respectively on month 1 and 3 after surgery, the Harris hip scores of patients in the PFBN group were significantly higher than the InterTAN group (t = 12.066 and 4.607, both P<0.001). One year after surgery, there were no significant differences in fracture reduction quality ( Z = - 0.300, P = 0.764) or incidence of adverse reactions ( χ 2 = 1.169, P = 0.280) between the two groups. Conclusion PFBN and InterTAN intramedullary nailing fixation are comparable in terms of long-term hip joint function recovery and fracture reduction quality in elderly patients with unstable IFF. However, compared with InterTAN intramedullary nailing fixation, PFBN internal fixation, despite its disadvantages such as longer surgical duration, more intraoperative blood loss, and more fluoroscopy times, can improve the recovery of hip joint anatomical structure and short-term hip joint function. |
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