老年股骨粗隆间骨折合并外侧壁骨折内固定治疗

Treatment of elderly patients with intertrochanteric fracture with external wall fracture

目的:分析老年股骨粗隆间骨折合并外侧壁骨折内固定治疗稳定性,主要是比较DHS+稳定加压板和PFNA内固定的治疗方法与效果,为老年股骨粗隆间骨折的临床治疗提供参考。方法:选取我院在2012年2月到2015年6月收治的50例老年股骨粗隆间骨折患者为研究对象,按照治疗方法的不同,分为观察组和对照组,对照组患者实施DHS+稳定加压板内固定,观察组实施PFNA内固定,观察比较两组患者不同固定手术基本情况,比较治疗后的稳定性,分析两组患者治疗效果。结果:两组内固定稳定性相比较,观察组患者稳定性明显高于对照组(P<0.05),在住院时间、手术时间、术中出血量相比较,观察组明显低于对照组(P<0.05),比较患者的术后下床时间、骨折愈合时间、术后内固定物松动率,观察组明显优于对照组,P<0.05差异有统计学意义。结论:在老年股骨粗隆间骨折合并外侧壁骨折内固定治疗中,应用PFNA内固定的方法,具有较好的治疗效果。PFNA内固定相比DHS+稳定加压板内固定,稳定性较高,手术时间短,能够有效减少患者的住院时间,减少术后的不良反应,获得较好的治疗效果,PFNA内固定值得在临床上应用。

Objective： to analyze the elderly femoral intertrochanteric fracture with the lateral wall fracture fixation stability,is relatively stable DHS ＋ and treatment method and effect of fixed plate and PFNA,to provide reference for clinical treatment of senile femoral intertrochanteric fracture. Methods： from June 2015 in our hospital 50 cases of elderly patients with femoral intertrochanteric fracture as the research object in February 2012,according to the different treatment methods,divided into observation group and control group,control DHS ＋ stable pressure plate fixation for the patients,the observation group received PFNA fixation were compared between the two groups of patients with different fixation the basic situation,the stability after treatment,analysis of two groups of patients with treatment effects. Results： the two groups of internal fixation stability compared to patients in the observation group stability was significantly higher than the control group（ P 〈 0. 05）,hospitalization time,operation time,intraoperative bleeding volume comparison,the observation group was significantly lower than the control group（ P 〈 0. 05）,compared with the postoperative ambulation time,fracture healing time,postoperative loosening of internal fixation rate of observation group was significantly better than the control group,there were significant differences in P 〈 0. 05. Conclusion： in the treatment of elderly patients with femoral intertrochanteric fracture combined with lateral wall fracture fixation,the method of PFNA internal fixation has good therapeutic effect. PFNA internal fixation compared with DHS ＋ stable pressure plate internal fixation,high stability,short operation time,can effectively reduce hospitalization time,reduce the postoperative adverse reactions,get a better therapeutic effect,PFNA fixation is worthy of clinical application.