Abstract: 【Abstract】〓Objective〓To investigate the effect of reconstruction nail and lengthened PFNA for treatment of femoral shaft fractures with femoral intertrochanteric fractures. Methods〓Sixty patients with femoral shaft fractures and intertrochanteric fractures were admitted in our hospital and divided into two group, the reconstruction nail group (n=30) treated with the reconstruction nail fixation and lengthened PFNA group treated with long proximal femoral nail antirotation. The operation time, intraoperative blood loss, fracture healing time, incision size, complications, Harris score, Lyshonlm score were compared between two groups. Results〓All cases were recovered and no severe complications occurred in two groups. The blood loss was higher and incision size was larger in lengthened PFNA group than that in reconstruction nail group (P<0.05). No statistically significant difference was found in operation time between two groups. Fracture healing time in reconstruction nail group longer than that in reconstruction nail group (P<0.05). Harris score of all postoperative time point was higher in lengthened PFNA group than in reconstruction nail group, and Lyshonlm scores in lengthened PFNA group were lower in 2 months after operation. Conclusion〓In the present paper, PFNA showed better the clinical efficacy oin treating femoral shaft fracture with intertrochanteric fracture.

Key words: Proximal femur, Antirotation intramedullary nail, Femoral intertrochanteric fracture, Femoral shaft fracture

摘要： 【摘要】 目的 研究重建钉和加长型PFNA用于股骨转子间骨折合并股骨干骨折治疗的临床疗效研究。方法 选取2012年1月~2014年6月到我院就诊并住院治疗的股骨转子间骨折合并骨干骨折的患者共60例为研究对象,分为两组: 为重建钉组和加长组,分别采用重建钉和加长型PFNA进行治疗,比较两组患者手术时间、术中出血量、骨折愈合时间、伤口长度、并发症、Harris评分、Lyshonlm评分。结果〓加长组的术中出血量、伤口长度均高于重建钉组(P<0.05),加长组的股骨转子间骨折的愈合时间和股骨干骨折的愈合时间也短于重建钉组(P<0.05),但两组手术时间差异无统计学意义。所有患者中只有一例发生切口感染,无其他严重并发症发生。加长组的Harris评分在术后各时间点均高于重建钉组,而Lyshonlm评分从术后第二个月开始之后的各时间点均低于重建钉组(P<0.05),但术后两周两组的Lyshonlm评分差异无统计学意义。结论 加长型PFNA用于股骨转子间骨折合并股骨干骨折治疗的临床疗效较好,患者恢复更快。

关键词: 股骨近端, 防旋髓内钉, 股骨转子间骨折, 股骨干骨折