闭合复位PFNA内固定治疗股骨转子间骨折的方法与临床心得分析

Analysis of Method and Clinical Experience of Closed Reduction PFNA Internal Fixation in Treatment of Intertrochanteric Fracture

目的探讨闭合复位股骨近端髓内钉(PFNA)内固定治疗股骨转子间骨折的方法与并临床心得。方法选择2014年10月—2016年10月期间该院收治的75例股骨转子间骨折患者,随机分为对照组(37例)和观察组(38例)。观察组采用闭合复位PFNA内固定治疗,对照组采用动力髋螺钉组内固定治疗,比较两组手术及术后并发症情况,并观察两组术后髋关节功能。结果观察组手术时间(65.34±10.14)min、手术出血量(174.24±48.57)m L、切口愈合时间(1.56±0.21)周、骨折愈合时间(10.36±1.21)周显著低于对照组(89.67±11.65)min、(358.5±79.41)m L、(2.17±0.37)周、(13.52±1.97)周,组间差异有统计学意义(P<0.05)。观察组并发症率(2.63%)显著低于对照组(16.22%),组间差异有统计学意义(P<0.05)。观察组术后髋关节功能优良率(92.11%)显著高于对照组(75.68%),组间差异有统计学意义(P<0.05)。结论股骨转子间骨折应用闭合复位PFNA内固定治疗效果可靠。

Objective To study the method and clinical experience of closed reduction PFNA internal fixation in treatment of intertrochanteric fracture. Methods 75 cases of patients with intertrochanteric fracture admitted and treated in our hospital from October 2014 to October 2016 were selected and randomly divided into two groups, the observation group with 38 cases were treated with closed reduction PFNA method, while the control group with 37 cases were treated with dynamic hip screw internal fixation, and the operation and postoperative complications were compared, and the postoperative hip joint function of the two groups was observed. Results The operation time, intraoperative bleeding amount, incision healing time and fracture healing time in the observation group were obviously lower than those in the control group, [（65.34±10.14）min,（174.24±48.57）m L,（1.56±0.21）weeks,（10.36±1.21）weeks vs（89.67±11.65）min,（358.5±79.41）m L,（2.17±0.37）weeks,（13.52±1.97）weeks], and the differences were obvious（P〈0.05）, and the complication rate in the observation group was obviously lower than that in the control group（2.63% vs 16.22%）, and the difference was obvious（P〈0.05）, and the excellent and good rate of postoperative hip joint function in the observation group was obviously higher than that in the control group,（92.11% vs 75.68%）, and the difference was obvious（P〈0.05）. Conclusion The effect of closed reduction PFNA internal fixation in treatment of intertrochanteric fracture is reliable.