微创复位术联合加长型抗旋转型股骨近端髓内钉内固定治疗股骨转子下骨折的疗效观察

Clinical Effect Observation of Minimally Invasive Reduction Combined with Extended Proximal Femoral Nail Antirotation Internal Fixation in Treatment of Subtrochanteric Fracture

目的探讨对股骨转子下骨折患者采用加长型抗旋转型股骨近端髓内钉内固定术联合微创复位术治疗的临床疗效。方法对我院骨科2014年6月至2015年6月收治的90例股骨转子下骨折患者进行观察,采用随机数字表法将患者分为试验组和参考组,每组各45例。参考组采用加长型抗旋转型股骨近端髓内钉(PFNA)内固定术治疗,试验组采用微创复位术联合PFNA内固定术治疗,观察两组患者的手术相关情况。随访一年,观察两组患者的治疗效果和恢复情况。结果试验组患者的平均住院时间、手术时间、骨折愈合时间、术中出血量均低于参考组(P<0.05);一年后随访结果显示,试验组患者治疗总有效率明显比参考组高,试验组患者的并发症发生率明显低于参考组(P<0.05)。结论微创复位术联合PFNA治疗股骨转子下骨折患者疗效安全可靠,可以缩短患者的康复时间,固定效果好,创伤性小,降低了术后并发症,具有较高的临床应用价值。

Objective to explore clinical effect of minimally invasive reduction combined with extended proximal femoral nail antirotation internal fixation in treatment of subtrochanteric fracture. Methods observe 90 cases subtrochanteric fracture patients in orthopedics department of our hospital from June 2014 to June 2015, divide them into experimental and reference group with random digital table method, 45 cases in each. Reference group was treated with extended PFNA internal fixation, and experimental group with minimally invasive reduction and PFNA internal fixation. Observe surgical related conditions of two groups. After one year followup, observe curative effect and recovery of two groups. Results average hospitalization time, surgical time, fracture healing time and bleeding amount of experimental group was all lower than reference group（P〈0.05）. One year follow-up results showed total effective rate of experimental group was significantly higher than reference group, complications incidence of experimental group was significantly lower than reference group,（P〈0.05）. Conclusion minimally invasive reduction combined with PFNA has safe and reliable curative effect in treatment of subtrochanteric fracture, can shorten rehabilitation time of patients with good fixation effect and less trauma, lower postoperative complications, which is of high clinical application value.