PFNA主钉长度对股骨转子间骨折微创手术 患者复位质量、术后稳定性的影响

The Effect of PFNA Main Nail Length on Reduction Quality and Postoperative Stability in Patients Undergoing Minimally Invasive Surgery for Intertrochanteric Fractures of the Femur

摘要: 目的：探究股骨近端髓内钉(PFNA)主钉长度对股骨转子间骨折微创手术患者复位质量、术后稳定性的影响。方法：以2024年1月~2025年12月为观察时段，期间收治130例股骨转子间骨折微创手术患者为数据分析基础，依据不同主钉长度分为长主钉组(n = 65，主钉长度 > 240 mm的PFNA内固定治疗)、短主钉组(n = 65，主钉长度 ≤ 240 mm的PFNA内固定治疗)。对组间手术相关指标、术后稳定性与髋关节功能(Harris髋关节功能评分量表)、并发症发生率开展比较。结果：相较于长主钉组，短主钉组的手术时间与住院时间较短(P < 0.05)，术中失血量与术中透视次数较少(P < 0.05)；长主钉组患者的术后稳定性评分结果高于短主钉组(P < 0.05)，髋关节功能评分结果，不同观察时点组间差异性均不显著(P > 0.05)；并发症发生率数据分析，组间差异性不明显(P > 0.05)；两组患者股骨颈缩短距离、股骨干缩短距离水平对比，差异性不明显(P > 0.05)。结论：PFNA不同长度主钉，用于股骨转子间骨折微创手术治疗，均可获得较高的复位质量和稳定性，对髋关节功能改善作用良好，且安全性相近，但短主钉相对恢复速度更快，在临床实践中需结合患者情况适当选择。

Abstract: Objective: To investigate the effect of the length of the main nail of the proximal femoral nail antirotation (PFNA) on the reduction quality and postoperative stability of patients undergoing minimally invasive surgery for intertrochanteric fractures of the femur. Method: From January 2024 to December 2025, a total of 130 minimally invasive surgical patients with intertrochanteric fractures were treated as the data analysis basis. According to different main nail lengths, they were divided into a long main nail group (n = 65, PFNA internal fixation treatment with main nail length > 240 mm) and a short main nail group (n = 65, PFNA internal fixation treatment with main nail length ≤ 240 mm). Compare the surgical related indicators, postoperative stability, hip joint function (Harris Hip Function Rating Scale), and incidence of complications between groups. Result: Compared with the long staple group, the short staple group had shorter surgical time and hospitalization time (P < 0.05), and less intraoperative blood loss and fluoroscopy frequency (P < 0.05); The postoperative stability score of patients in the long staple group was higher than that in the short staple group (P < 0.05), and the hip joint function score showed no significant difference between the groups at different observation points (P > 0.05); The incidence of complications data analysis showed no significant difference between the groups (P > 0.05); There was no significant difference in the level of femoral neck shortening distance and femoral shaft shortening distance between the two groups of patients (P > 0.05). Conclusion: PFNA main nails of different lengths can achieve high reduction quality and stability in minimally invasive surgical treatment of intertrochanteric fractures of the femur, and have a good effect on improving hip joint function with similar safety. However, short main screws have a relatively faster recovery speed, and should be selected appropriately according to the patient’s situation in clinical practice.