PFNA内固定治疗股骨粗隆间骨折手术安全性分析

Safety Analysis of PFNA Internal Fixation in the Treatment of Intertrochanteric Fracture

目的探析股骨粗隆间骨折患者应用PFNA(股骨近端螺旋刀片抗旋髓内钉)内固定治疗的安全性。方法对本院2015年10月~2017年6月期间收治的96例股骨粗隆间骨折患者进行研究。按照随机原则分为两组,参照组与研究组,各48例。参照组患者应用DHS(动力髋螺钉)内固定治疗,研究组患者应用PFNA内固定治疗,对两组患者手术指征、临床疗效及并发症发生情况进行统计比较。结果研究组患者手术时间、术中出血量、住院时间、负重时间明显少于参照组患者,组间对比具有统计学差异(P<0.05)。研究组患者临床优良率为97.9%,明显高于参照组患者的85.4%,两组比较具有统计学差异(P<0.05)。研究组患者并发症发生率4.2%,明显低于参照组患者的18.8%,组间比较具有统计学差异(P<0.05)。结论在股骨粗隆间骨折治疗中,PFNA内固定治疗效果显著优于DHS内固定,具有安全、可靠的优势,可在临床中应用与推广。

Objective To evaluate the safety of PFNA（proximal femoral screw blade anti rotation intramedullary nail） internal fixation for intertrochanteric fracture. Methods From October 2015 to June 2017, 96 cases of intertrochanteric fracture were divided into two groups, namely, the reference group and the study group, each with 48 cases. The patients in the reference group were treated with DHS（dynamic hip screw） internal fixation, and the patients in the study group were treated with PFNA internal fixation. The operation indications, clinical efficacy and complications of the two groups were statistically compared. Results The operation time, the amount of bleeding, the time of hospitalization and the time of loading were significantly less in the study group than those in the reference group, and the difference between the two groups was statistically significant（P〈 0.05）. The clinical excellent rate of the patients in the study group was 97.9%, significantly higher than that in the reference group, and the difference between the two groups was statistically significant. The difference between the 85.4% groups was statistically significant（P 〈 0.05）. The incidence of complications in the study group was 4.2%, which was significantly lower than that in the reference group, and there was a statistically significant difference between the 18.8% groups（P 〈 0.05）. Conclusion In the treatment of intertrochanteric fracture, the effect of PFNA internal fixation is better than that of DHS internal fixation, and it has the advantages of safety and reliability, and can be applied and popularized in clinical practice.