股骨近端防旋髓内钉(PFNA)与骨水泥加长柄人工股骨头置换治疗IFOF的疗效

Effect of(PFNA)and Bone Cement plus Long Handle Artificial Femoral Head Replacement on IFOF

目的分析在治疗股骨粗隆间骨折(IFOF)中应用股骨近端防旋髓内钉(PFNA)与骨水泥加长柄人工股骨头置换治疗的效果。方法本次研究选取2017年1月—2018年12月期间收治的60例股骨粗隆间骨折患者作为本次研究对象,根据治疗方法的不同分为两组,各30例,其中对照组给予骨水泥加长柄人工股骨头置换治疗,观察组给予PFNA治疗,比较两组效果。结果两组患者手术情况对比,观察组患者在手术时间、术中出血量、切口长度方面对比,均优于对照组;而对照组患者在住院时间、下地负重行走时间方面对比,均优于观察组,两组患者手术情况比较差异有统计学意义(P<0.05)。组间并发症发生情况比较,两组并发症发生率分别为16.7%、6.7%,其中观察组并发症发生率明显更低,差异有统计学意义(P<0.05)。组间术后各时间段髋关节功能评分对比,两组患者术后1个月、术后12个月这两个时间段的髋关节评分比较差异无统计学意义(P>0.05);而两组患者术后3个月、术后6个月这两个时间段髋关节评分对比,对照组评分明显更高,比较差异有统计学意义(P<0.05)。组间术后半年生活质量评分对比,对照组在躯体功能、心理功能、社会功能、物质生活状态四个维度方面的评分均比对照组高,比较差异有统计学意义(P<0.05)。结论在治疗股骨粗隆间骨折中,股骨近端防旋髓内钉与骨水泥加长柄人工股骨头置换治疗都发挥着重要的作用,其中股骨近端防旋髓内钉治疗具有手术时间短、创伤小、出血少的特点,而骨水泥加长柄人工股骨头置换治疗具有住院时间短、恢复快的特点。两种手术方法各有优势,所以在选择方面应该根据患者实际病情合理选择。

Objective To analyze the effect of(PFNA)and cement plus long handle artificial femoral head replacement in the treatment of intertrochanteric fracture of femur with(PFNA)and bone cement.Methods From January 2017 to December 2018,60 patients with intertrochanteric fracture of femur were selected as the subjects of this study.According to the different treatment methods,they were divided into two groups,30 cases in each group.The control group was treated with bone cement and long handle artificial bone replacement,and the observation group was treated with PFNA,and the effects of the two groups were compared.Results The operation time,intraoperative blood loss and incision length of the two groups were better than those of the control group,while the hospitalization time and walking time of the ground load in the control group were better than those in the observation group,and there was significant difference between the two groups(P<0.05).The incidence of complications in the two groups was 66.7%and 6.7%respectively,and the incidence of complications in the observation group was significantly lower than that in the observation group(P<0.05).The scores of hip joint function in the two groups were compared at each time period after operation.One month after operation and 12 months after operation,the patients in the two groups were treated with hip joint function score.There was no significant difference in the hip scores between the two groups(P>0.05).The scores of hip joint in the two groups were significantly higher than those of the control group after 3 months and 6 months after the operation(P<0.05).The scores of the four dimensions of physical function,psychological function,social function and physical life of the control group were higher than that of the control group,and the contrast was significant(P<0.05).Conclusion In the treatment of intertrochanter fracture of femur,both proximal anticircumflex intramedullary nail and bone cement plus long handle artificial femoral head replacement play an important role.The treatment of proximal circumflex intramedullary nail has the characteristics of short operation time,less trauma and less bleeding,while the treatment of bone cement plus long handle artificial femoral head replacement has the characteristics of short hospitalization time and fast recovery.The two surgical methods have their own advantages,so the choice should be reasonable according to the actual condition of the patient.