侧卧位与平卧位下股骨近端防旋髓内钉治疗股骨转子间骨折的临床效果分析

Analysis of Clinical Effect of Lateral Position and Supine Position Under the Proximal Femoral Intramedullary Nail in Treatment of Femoral Intertrochanteric Fracture

目的探讨侧卧位与平卧位下股骨近端防旋髓内钉(PFNA)治疗肥胖患者股骨转子间骨折的疗效。方法回顾性分析59例应用PFNA内固定治疗股骨转子间骨折患者的临床资料,随机分为侧卧位组和平卧位组,比较两组患者的手术时间、术中出血量、转子顶端切口长度、骨折愈合时间及髋关节Harris评分等。结果侧卧位组患者手术时间、转子顶端切口长度短于平卧位组,差异有统计学意义(P<0.05),侧卧位组患者术中出血量少于平卧位组,差异有统计学意义(P<0.05),两组患者骨折愈合时间、髋关节Harris评分等比较差异均无统计学意义(P>0.05)。结论侧卧位行PFNA治疗肥胖患者股骨转子间骨折,降低了手术难度,缩短了手术时间和手术切口长度,减少了术中出血量,较平卧位行PFNA治疗肥胖患者股骨转子间骨折有明显优势。

Objective The paper explores the curative effects of proximal femur nail anti-rotation （PFNA） on obese patients’ intertrochanteric fracture in lateral position and horizontal position.MethodsThe paper makes a retrospective analysis on the clinical data of 59 cases applying PFNA internal ifxation for the treatment of intertrochanteric facture, and divides the cases into the lateral position group and the horizontal position group randomly to compare the two groups in terms of duration of operation,blood loss during operation, incision length on trochanter top, facture healing time and Harris hip score.Results Lateral position group’s duration of operation and incision length on trochanter top are signiifcantly shorter than those of horizontal position group, of which the difference shows the statistical significance （P〈0.05）, lateral position group’s blood loss during operation is obviously less than that of horizontal position group, of which the difference shows the statistical significance （P〈0.05）, for fracture healing time and Harris hip score, two groups show no statistical signiifcance （P〉0.05）. Conclusion The horizontal-position PFNA for obese patients’ intertrochanteric fracture decreases operation dififculty, shortens operation time and length of surgical incision and reduces blood loss in operation, thus having obvious advantages compared with lateral-position PFNA for obese patients’ intertrochanteric fracture.