侧卧位闭合复位股骨近端防旋髓内钉内固定治疗高龄患者股骨粗隆间骨折临床研究

Peripheral position for proximal femoral anti-rotation intramedullary nail internal fixation of femoral intertrochanteric fracture in elderly patients

目的探讨侧卧位闭合复位股骨近端防旋髓内钉(PFNA)内固定治疗高龄患者股骨粗隆间骨折临床疗效。方法选取自2012年3月至2016年3月厦门大学附属成功医院收治的136例股骨粗隆间骨折高龄患者为研究对象。采用随机数字表法将患者分为侧卧位组(n=68)与仰卧位组(n=68)。侧卧位组采取侧卧位应用PFNA内固定治疗,仰卧位组采取仰卧位应用PFNA内固定进行治疗。比较两组患者的平均手术时间、平均手术出血量、平均住院时间、平均骨折愈合时间、切口长度、Harris髋关节评分及发症发生情况。结果侧卧位组患者的平均手术时间为(50.29±5.95)min,明显少于仰卧位组的(55.35±5.71)min,两组比较,差异有统计学意义(P<0.05)。侧卧位组患者的平均出血量为(129.31±40.08)ml,明显少于仰卧位组的(146.04±43.51)ml,两组比较,差异有统计学意义(P<0.05)。两组患者的平均住院时间、平均骨折愈合时间、切口长度、Harris髋关节评分及并发症发生率比较,差异均无统计学意义(P>0.05)。结论高龄患者股骨粗隆间骨折侧卧位闭合复位PFNA内固定具有操作方便、手术时间短、出血量少的优势。

Objective To investigate the effect of peripheral position for proximal femoral anti-rotation intramedullary nail(PFNA)internal fixation of femoral intertrochanteric fracture in elderly patients.Methods A retrospective study was performed on 136 cases of elderly patients with femoral intertrochanteric fracture who were admitted from March 2012 to March 2016.Patients were randomly divided into the peripheral position group(n=68)and the supine position group(n=68).Lateral position was used for the treatment of intramedullary nail internal fixation of proximal femoral head in the peripheral position group.Supine position was used for the treatment of intramedullary nail internal fixation of proximal femoral head the supine position group.The mean operation time,mean surgical bleeding,mean length of hospital stay,mean fracture healing time,incision length,Harris hip score and complication rate were compared between the two groups.Results The mean operation time in the peripheral position group was(50.29±5.95)minutes,which was significantly less than(55.35±5.71)minutes in the supine position group(P<0.05).The mean surgical bleeding in the peripheral position group was(129.31±40.08)ml,which was significantly less than(146.04±43.51)ml in the supine position group(P<0.05).There was no statistically significant difference in the mean hospitalization time,mean fracture healing time,incision length,Harris hip score and complication rate between the two groups(P>0.05).Conclusion The peripheral position for PFNA internal fixation of femoral intertrochanteric fracture in elderly patients has the advantages such as convenient operation,short operation time and less operative bleeding.