髓内针内固定治疗老年股骨粗隆间骨折疗效的生物力学分析

Biomechanical analysis of the internal fixation with intramedullary nail for intertrochanteric fractures in elderly patients

目的通过比较闭合复位与切开复位髓内针内固定治疗老年股骨粗隆间骨折的疗效,探讨影响髓内针内固定治疗老年股骨粗隆间骨折疗效的主要因素。方法将股骨粗隆间骨折患者随机分为实验组与对照组,实验组进行闭合复位髓内针内固定术治疗,对照组进行切开复位髓内针内固定术治疗,比较两组的手术时间、住院时间及生活能力得分。结果实验组的手术时间短于对照组,差异具有统计学意义(P<0.05),而在住院时间和生活能力得分上,两组之间的差异不具有统计学意义(P>0.05)。结论切开或闭合复位方式不是影响髓内针内固定治疗老年股骨粗隆间骨折疗效的主要因素,髓内针内固定运用的中轴性固定效应,是影响疗效的主要因素之一。因此在临床可根据老年患者的具体情况选择合适的复位方式,以达到更好的治疗效果。

Objective To investigate the main factors in the intramedullary nail fixation of intertrochanteric fractures in elderly patients by comparing the curative effects of closed reduction and open reduction in the intramedullary nail fixation of intertrochanteric fractures.Methods The femoral intertrochanteric fracture patients were randomly divided into experimental group and control group.The experimental group was treated with closed reduction and intramedullary fixation,and the control group was treated with open reduction and internal fixation.The parameters of operation time,days in hospital,and the scores of activities of daily living were compared.Results The operation time of the experimental group was shorter than that of the control group （P〈0.05）,the differences of hospitalization time and the scores of activities of daily living were not significant （P〉0.05）.Conclusions Reduction mode does not affect the efficacy of intramedullary nail fixation for the intertrochanteric fracture,however the axial fixed effect of intramedullary fixation is one of the main factor for the curative effect.Therefore,the doctor may select the proper reduction mode according to the patient＇s condition for a better therapeutic effect.