股骨近端防旋转髓内钉固定联合应用唑来膦酸治疗骨质疏松性股骨转子间骨折疗效

Proximal femur prevent rotation intramedullary nail fixed joint application of azole to phosphonic acidtreatment of osteoporotic femoral fracture curative effect between rotor

目的：剖析骨质疏松性股骨转子间骨折用股骨近端防旋转髓内钉固定＋唑来膦酸的疗效.方法：抽取2013年2月-2015年4月,我科接收的骨质疏松性股骨转子间骨折患者,共计70例.按照奇偶数字分组原理,将70例患者分成观察组和对照组2组.观察组行股骨近端防旋转髓内钉固定术,对照组在观察组的基础上加用唑来膦酸.观察2组骨折创口的愈合情况,比较腰椎与健侧髋部的骨密度以及再骨折发生率等治疗指标.结果：经测定,观察组术后1年的健侧髋部骨密度为（0.69±0.16）g/cm^2、腰椎骨密度为（0.74±0.15）g/cm^2,对照组分别为（0.72±0.13）g/cm^2、（0.79±0.14）g/cm^2.观察组明显低于对照组.2组对比,差异具有统计学意义（P〈0.05）.观察组的再骨折发生率为2.85%,对照组为14.29%.观察组明显低于对照组.2组对比,差异具有统计学意义（P〈0.05）.观察组的骨折愈合时间为14.25±2.21周、术后1年Harris评分为83.14±6.17分,对照组分别为16.38±2.94周、74.25±5.42分.观察组明显优于对照组.2组对比,差异具有统计学意义（P〈0.05）.结论：于骨质疏松性股骨转子间骨折的股骨近端防旋转髓内钉固定术中合理加用唑来膦酸,可增加患者的骨密度,降低再骨折发生率,缩短骨折愈合时间.

Objective：Analysis of osteoporotic femoral fracture with proximal femoral rotation prevention between rotor intramedullary nail fixed to the curative effect of phosphonic acid ± azole.Methods：to extract-in April 2015,in February 2013,our department receives the osteoporotic patients with femoral fracture between the rotor and a total of 70 cases.According to the odd and even number grouping principle,70 subjects were divided into a,b two groups.Students＇ proximal femoral rotation prevention and intramedullary nail fixation,on the basis of the first division b used azole phosphonic acid.Observe two groups of fracture healing of wounds,comparing the lumbar spine and the contralateral hip bone mineral density and fracture incidence again.Results：the mensuration,the first division after 1 year of the contralateral hip bone mineral density for g/cm^2 （0.69 ± 0.16）,（density of g/cm^2 （0.74 ± 0.15）,（0.72±0.13） respectively b g/cm^2,（0.79-0.14） g/cm^2.Students＇ significantly lower than group b.Compared the two groups,the difference statistically significant （P 〈 0.05）.First division and fracture incidence was 2.85%,group b was 14.29%.Students＇ significantly lower than group b.Compared the two groups,the difference statistically significant （P 〈 0.05）.Students＇ fracture healing time was （14.25 ± 2.21） weeks,after 1 year for Harris score （83.14±6.17）,group b （16.38 ± 2.94） for weeks,respectively （74.25±5.42）.B was obviously better than the first division.Compared the two groups,the difference statistically significant （P 〈 0.05）.Conclusion：in osteoporotic femoral fractures of the proximal femur between rotor and anti rotation intramedullary nail fixation of reasonable use azole to phosphonic acid,could increase the patient＇s bone mineral density,reduce the incidence of fracture,shorten fracture healing time.