CAJ | 학술논문

目的：探讨反向股骨远端微创内固定系统(less invasive stabilization system ,LISS)与防旋股骨近端髓内钉( proximal femoral nail antirotation,PFNA)治疗老年人股骨粗隆间粉碎性骨折的临床疗效。方法自2007年2月~2012年6月收治52例高龄复杂不稳定型股骨粗隆间骨折的患者，25例应用反向 LISS治疗，男9例，女16例，年龄63～89岁，27例应用PFNA治疗，男10例，女17例，年龄65～88岁，并对两组手术时间，术中出血，切口长度，髋关节功能情况进行分析对比。结果所有患者获得随访时间9～18个月，平均13.1个月，全部患者均骨折愈合，无伤口感染，髋内翻及内固定切出等并发症，PFNA组较反向 LISS组切口长度较短，统计学有差异，PFNA组较反向LISS组在手术时间，术中出血量等方面均略有优势，但无明显差异，按照Harris髋关节评分标准，反向LISS组和PFNA组相比较无明显差异。结论反向LISS及PFNA治疗老年复杂股骨粗隆间粉碎性骨折临床疗效都比较理想均为较好的内固定物。
목적：탐토반향고골원단미창내고정계통(less invasive stabilization system ,LISS)여방선고골근단수내정( proximal femoral nail antirotation,PFNA)치료노년인고골조륭간분쇄성골절적림상료효。방법자2007년2월~2012년6월수치52례고령복잡불은정형고골조륭간골절적환자，25례응용반향 LISS치료，남9례，녀16례，년령63～89세，27례응용PFNA치료，남10례，녀17례，년령65～88세，병대량조수술시간，술중출혈，절구장도，관관절공능정황진행분석대비。결과소유환자획득수방시간9～18개월，평균13.1개월，전부환자균골절유합，무상구감염，관내번급내고정절출등병발증，PFNA조교반향 LISS조절구장도교단，통계학유차이，PFNA조교반향LISS조재수술시간，술중출혈량등방면균략유우세，단무명현차이，안조Harris관관절평분표준，반향LISS조화PFNA조상비교무명현차이。결론반향LISS급PFNA치료노년복잡고골조륭간분쇄성골절림상료효도비교이상균위교호적내고정물。
Objective To compare the therapeutic Effectiveness of inverted less invasive stabilization system(LISS)and proximallfemorallnaillanlirotafion (PFNA)in treatment of complex unstable intertrochanteric fracture in aged,and to investigate the selective strategy of the internallfixation. Methods From February 2007 to June 2012,52 senior patients with complex andunstable intertrochanteric fractures were treated. Among them 25 patients were treated by inverted LISS,including 9 males and 16 females,aged from 63 to 89 years;27 patients were treated by PFNA,including 10 males and 17 females,aged from 65 to 88 years old. The mean operating time,blood loss,incision length, bone healing,hip function were analyzed and compared. Results Allpatients were followed up for 9 to 18 months (averaged 13.1 months). Allfractures got bone healing. No complications such as wound infection,varus and internallfixation cut out occurred.There were significant dif erences in incision length between two groups. The operative time,blood loss,in PFNA group had a slight ascendant than that in LISS inversion group,but there were no significant dif erences. According to postoperative Harris hip score outcome of LISS inversion group compared with the PFNA group,there was no significant dif erence. Conclusion Both of PFNA and LISS have ideallEffect in treatment of complex unstable intertrochanteric fracture in aged,and are good internallfixations.