骨质疏松股骨粗隆间骨折的股骨近端防旋髓内钉固定手术的效果与安全性评价

A study of the efficacy and safety evaluation of proximal femoral nail anti rotation fixation for osteoporotic intertrochanteric fractures

目的分析骨质疏松股骨粗隆间骨折的股骨近端防旋髓内钉(proximal femoral nail anti rotation,PFNA)固定手术的效果与安全性。方法骨质疏松股骨粗隆间骨折病人89例,将89例病人分为两组,观察组44例,接受股骨近端防旋髓内钉手术治疗;对照组45例,接受动力髋螺钉(dynamic hip screw,DHS)手术治疗。比较两组病人的疗效与安全性。结果观察组的手术时间为(67. 53±8. 47)分钟,出血量为(170. 25±23. 67) ml,对照组分别为(102. 41±8. 05)分钟和(430. 58±26. 37) ml,两组比较,差异有统计学意义(P <0. 05);观察组疗效为差等的病人比例低于对照组;两组间骨折愈合时间以及疗效的优良率等比较,差异无统计学意义(P> 0. 05);术后观察组的Harris评分为83. 22±12. 05,对照组为80. 45±15. 14,两组比较差异无统计学意义(P>0. 05);两组病人术中术后并发症比较,差异无统计学意义(P> 0. 05)。结论 PFNA治疗骨质疏松性股骨粗隆间骨折,手术时间更短,术中损伤更小,各种并发症的发生风险也不高。

Objective To analyze and discuss the efficacy and safety of proximal femoral nail anti rotation（ PFNA） fixation for osteoporotic femoral intertrochanteric fractures. Methods A total of 89 patients with osteoporotic intertrochanteric fractures were included in the study and divided into observation group including 44 patients receiving proximal femoral nail anti-rotation surgical treatment. The control group included 45 patients receiving dynamic hip screw（ DHS） surgical treatment. The efficacy and safety of the two groups were compared and analyzed. Results The operation time of the observation group[（ 67. 53 ± 8. 47） min]was lower than that of the control group[（ 102. 41 ± 8. 05） min] and the blood loss was also lower than that of the control group[（ 170. 25 ± 23. 67） ml vs（ 430. 58 ± 26. 37） ml],and the difference was statistically significant（ P〈0. 05）. Efficacy evaluation showed that the proportion of patients with poor efficacy in the observation group was lower than that in the control group. There was no statistically significant difference between the two groups in fracture healing time and rate of effectiveness（ P〉0. 05）. The Harris score of the observation group after surgery was 83. 22 ± 12. 05,and that of the control group was 80. 45 ± 15. 14. There was no significant difference（ P〉0. 05） between the two groups.Conclusion The treatment of osteoporotic femoral intertrochanteric fractures with proximal femoral nail anti-rotation has a shorter operation time,less intraoperative damage,and a low risk of various complications. It has many advantages.