PFNA治疗股骨粗隆间骨折的疗效观察

Efficacy observation of PFNA in treatment of femoral intertrochanteric fracture

目的对防旋转股骨近端髓内钉（PFNA）治疗股骨粗隆间骨折的疗效进行分析。方法将我院2013年1月~2014年8月收治的144例股骨粗隆间骨折患者随机分为对照组和观察组,对照组72例患者行动力髋螺钉（DHS）内固定,观察组72例患者行PFNA内固定,对比两组患者的手术指标、治疗效果及术后并发症的发生率。结果观察组患者的手术时间、住院时间、负重时间及骨折愈合时间显著短于对照组,术中出血量明显少于对照组,差异具有统计学意义（P〈0.05）。观察组患者手术后的髋关节Harris评分为（90.8±6.2）分,对照组为（81.5±7.2）分,观察组术后的髋关节Harris评分明显高于对照组,差异有统计学意义（P〈0.05）。观察组患者的治疗优良率为97.22%,对照组为76.39%,观察组患者的治疗优良率明显高于对照组,差异有统计学意义（P〈0.05）。观察组患者的并发症发生率为4.17%,对照组为13.89%,观察组患者的并发症发生率明显低于对照组,差异有统计学意义（P〈0.05）。结论对股骨粗隆间骨折患者采用PFNA内固定治疗具有创伤小、效果理想、安全性高等优点,值得临床上推广应用。

Objective To analyze and discuss the efficacy of proximal femoral nail antirotation （PFNA） in the treatment of femoral intertrochanteric fractures. Methods A total of 144 patients with femoral intertrochanteric fractures treated in our hospital from January 2013 to August 2014 were randomly divided into the control group and the observation group, with 72 patients in each group. The control group was given dynamic hip screw （DHS） internal fixation and the observation group was given PFNA internal fixation. The surgical indicators, treatment effects and incidences of postoperative complications of the two groups were compared. Results The observation group was significantly shorter than the control group in the surgical time, length of hospital stay, weight bearing time and fracture healing time, and was significantly less than the control group in the intraoperative bleeding amount, with statistically significant differences （P〈0.05）. The postoperative hip joint Harris score of the observation group was （90.8±6.2） points and that of the control group was （81.5±7.2） points; the observation group was significantly higher than the control group in the hip joint Harris score, with statistically significant difference（P〈0.05）. The treatment effective rate of the observation group was 97.22% and that of the control group was 76.39%; the observation group was significantly higher than the control group in the treat- ment effective rate, with statistically significant difference（P〈0.05）. The incidence of complications of the observation group was 4.17% and that of the control group was 13.89%; the observation group was significantly lower than the control group in the incidence of complications, with statistically significant differenee（P〈0.05）. Conclusion In the treat- ment of patients with femoral intertrochanteric fractures, the application of PFNA internal fixation has the advantages of small trauma, ideal effects and high safety, which is worthy of clinical promotion and application.