股骨近端防旋髓内钉结合抗骨质疏松药物治疗老年股骨粗隆间骨折患者的临床效果

Effect of proximal femoral intramedullary nailing combined with anti-osteoporosis drugs in the treatment of intertrochanteric fracture in elderly patients

目的探讨股骨近端防旋髓内钉（proximal femoral nail antirotation,PFNA）结合抗骨质疏松药物治疗老年股骨粗隆间骨折的临床效果。方法选取2014年10月-2015年10月在浙江舟山普陀区人民医院骨科接受PFNA手术治疗的股骨粗隆骨折骨质疏松患者80例,按照入院时间分为单纯手术（对照）组和联合（试验）组,各40例。2组均采用PFNA手术治疗,试验组术后给予钙剂＋骨化三醇＋降钙素治疗,对比2组的骨折愈合效果及术后患者髋关节功能。结果试验组的骨痂出现时间、骨折愈合时间均低于对照组,差异具有统计学意义（P〈0.05）;术后1、3个月,试验组的骨痂评分显著高于对照组（P〈0.05）;术后6个月,试验组的骨密度测定值高于对照组（P〈0.05）,试验组的髋关节优良率90.00%高于对照组72.50%（P〈0.05）。结论 PFNA结合抗骨质疏松药物治疗老年股骨粗隆间骨折有利于促进骨折愈合,改善患者骨质疏松。

Objective To investigate the clinical effect of the proximal femoral nail anti rotation nail combined with anti osteoporosis drugs in the treatment of intertrochanteric fracture in elderly patients. Methods From October 2014 to October 2015 in our hospital department of orthopedics for PFNA surgical treatment of 80 cases of intertrochanteric fractures in osteoporotic patients,according to the time of admission were divided into simple operation group（ control group） and combined group（ treatment group）,with 40 cases in each group. Both the two groups were treated with PFNA surgery,treatment group were treated with ossification in three alcohol,calcium and calcitonin in the treatment of patients with hip. The fracture healing and hip function were compared between the two groups. Results The treatment group callus appear time,healing time were lower than the control group,the difference was statistically significant（ P〈0. 05）; One and three months after operation,the callus scoring of treatment group was higher than control groups（ P〈0. 05）; Six months after operation,the bone density of treatment group were higher than control group（ P〈0. 05）,the satisfactory rate of treatment group 90. 00% was higher than the control group72. 50%（ P〈0. 05）. Conclusion PFNA combined with anti-osteoporosis drugs in the treatment of elderly patients with intertrochanteric fracture is conducive to promote fracture healing,improve the condition of osteoporosis in patients with osteoporosis.