股骨近端防旋髓内钉与股骨近端仿生髓内钉治疗不稳定型老年股骨转子间骨折疗效的比较分析

Comparative Analysis of the Efficacy of Proximal Femoral Nail Antirotation and Proximal Femur Bionic Nail in the Treatment of Unstable Elderly Intertrochanteric Femur Fractures

摘要: 目的：比较股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation, PFNA)与股骨近端仿生髓内钉(Proximal Femur Bionic Nail, PFBN)治疗不稳定型老年股骨转子间骨折的疗效差异。方法：对我院2022年7月~2023年7月收治的不稳定型老年股骨转子间骨折患者共69例进行回顾性分析，按治疗方式将其分为PFNA组和PFBN组，PFNA组39例，PFBN组30例。分别对两组的围手术期、随访和影像资料进行比较。结果：围手术期两组间在手术时长、术中透视次数、术中出血量、住院时长差异无统计学意义(P > 0.05)；术后患者辅助下地时间、患肢完全负重时间、VAS评分和髋关节Harris评分，PFBN组均优于PFNA组，差异具有统计学意义(P < 0.05)；在影像学结果上，术后6个月，PFBN组颈干角显著大于PFNA组，差异具有统计学意义(P < 0.05)。结论：对于不稳定型老年股骨转子间骨折，PFBN治疗相较于PFNA治疗，可使患者早期进行负重活动，远期髋关节功能恢复更优，在提高患者生活质量上具有优势。

Abstract: Objective: A comparison was made between the efficacy of Proximal Femoral Nail Antirotation (PFNA) and Proximal Femur Bionic Nail (PFBN) in the treatment of unstable geriatric intertrochanteric fractures. Methods: A retrospective analysis was conducted on a total of 69 patients with unstable intertrochanteric fractures of the femur admitted to our hospital from July 2022 to July 2023. These patients were divided into two groups based on the treatment method: the PFNA group, consisting of 39 cases, and the PFBN group, consisting of 30 cases. The perioperative, follow-up, and imaging data of the two groups were compared. Results: There were no statistically significant differences in operation time, intraoperative fluoroscopy times, intraoperative blood loss and hospital stay between the two groups during the perioperative period (P > 0.05); the PFBN group performed better than the PFNA group in terms of the postoperative patient assisted weight-bearing time, full weight-bearing time of the affected limb, VAS scores and Harris hip scores, with statistically significant differences (P < 0.05). In terms of imaging results, at 6 months postoperatively, the collodiaphysial angle was significantly greater in the PFBN group than in the PFNA group, and the difference was statistically significant (P < 0.05). Conclusion: For unstable geriatric intertrochanteric fractures, compared with PFNA, PFBN allows early weight-bearing activities and has advantages in improving patients’ quality of life.