闭合复位股骨近端防旋髓内钉内固定术治疗老年股骨粗隆间骨折患者的效果研究

Effect of Closed Reduction and Proximal Femoral Nail Anti-Rotation Intramedullary Fixation in the Treatment of Elderly Patients with Intertrochanteric Fracture of Femur

目的:探究闭合复位股骨近端防旋髓内钉(PFNA)内固定术治疗股老年骨粗隆间骨折患者的效果。方法:选择2017年1月—2023年10月南昌市新建区人民医院收治的80例老年股骨粗隆间骨折患者为研究对象,按抽签法将其随机分为对照组与研究组,各40例。对照组采用股骨近端锁定钢板内固定术,研究组采用闭合复位PFNA内固定术。比较两组临床指标、髋关节功能、髋关节活动度、疼痛程度及并发症发生情况。结果:研究组手术耗时、术后首次下床时间、平均住院时间、骨折愈合时间均短于对照组,术中失血量少于对照组,差异均有统计学意义(P<0.05)。术后3、6个月,研究组髋关节功能评分及髋关节活动度均高于对照组,差异均有统计学意义(P<0.05)。术后6 h、1 d、2 d、3 d,研究组疼痛程度评分均低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为5.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论:闭合复位PFNA内固定术治疗老年股骨粗隆间骨折患者,可减少术中失血量,缩短手术耗时与术后首次下床时间、平均住院时间、骨折愈合时间,促进髋关节功能及活动度恢复,降低疼痛程度,且具有较好的安全性。

Objective:To investigate the effect of closed reduction and proximal femoral nail anti-rotation(PFNA)intramedullary fixation in the treatment of elderly patients with intertrochanteric fracture of femur.Methods:A total of 80 elderly patients with intertrochanteric fracture of femur they were treated in Xinjian District People’s Hospital of Nanchang City from January 2017 to October 2023 were selected as the study objects,randomly divided into a control group and a study group by drawing lots,with 40 cases in each group.The control group underwent proximal femoral locking plate internal fixation,the study group underwent closed reduction PFNA intramedullcoy fixation.The clinical indexes,hip function,hip motion,pain degree and the occurrence of complications were compared between the two groups.Results:The operation time,the first time to get out of bed after surgery,the average length of hospital stay and the fracture healing time in the study group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,with statistical significance(P<0.05).At 3 and 6 months after surgery,hip function scores and hip motion in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).At 6 h,1,2 and 3 d after surgery,the scores of pain degree in the study group were lower those that in the control group,the differences were statistically significant(P<0.05).The complication rate of the study group was 5.00%,which was lower than 20.00%of the control group,the difference was statistically significants(P<0.05).Conclusion:In elderly patients with intertrochanteric fracture of femur,closed reduction with PFNA intramedullgry fixation can reduce the intraoperative blood loss,shorten the operation time,the first postoperative getting out of bed,the average length of hospital stay,the fracture healing time,promote the recovery of hip function and motion,reduce the degree of pain,have a good safety.