股骨近端防旋髓内针与解剖锁定钢板治疗老年股骨粗隆骨折的疗效观察

Observation of proximal femoral anti rotation intramedullary nail and anatomical locking plate in the treatment of senile femoral intertrochanteric fracture

目的探讨股骨近端防旋髓内针与解剖锁定钢板治疗老年股骨粗隆骨折的疗效差异。方法选取2014年6月至2016年6月入住该院进行治疗的76例老年股骨粗隆骨折患者作为研究对象,根据治疗方法的不同将其分为A、B两组,每组38例,A组患者采用股骨近端防旋髓内针治疗,B组患者采用解剖锁定钢板治疗。比较两组患者术后效果、髋关节功能及内固定的生物学性能。结果 A组术中出血量、手术时间、骨性愈合时间、刀口长度及下床负重时间明显优于B组,差异有统计学意义(P<0.05);A组术后3、6个月Harris评分分别为(78.51±2.24)、(89.88±2.78)分,明显高于B组术后3、6个月Harris评分[(73.23±2.13)、(82.32±2.27)分,P<0.05];A组轴向压缩、破坏载荷明显大于B组,而扭转刚度则小于B组,差异有统计学意义(P<0.05)。结论股骨近端防旋髓内针治疗老年股骨粗隆骨折的效果明显优于解剖锁定钢板治疗,能有效促进患者髋关节功能的恢复,加快骨折愈合。

Objective To investigate the difference of curative effect between proximal femoral anti rotation intramedullary nail and anatomical locking plate in the treatment of senile femoral intertrochanteric fracture. Methods From June 2014 to June 2016,a total of 76 cases of elderly patients with femoral intertrochanteric fractures in Mudan District Chinese Medicine Hospital were recruited as research objects in this study,and divided into group A and group B according to different treatment methods,38 patients with proximal femoral anti rotation intramedullary nail in group A,38 patients with anatomy locking plate for the treatment as group B.The postoperative effects,hip function and biological performance of two groups were compared. Results The operative bleeding volume,operation time,healing time,incision length and bed load time in group A were higher than those of group B ( P <0.05).Harris score (78.51±2.24) after 3 months and Harris score ( 89.88± 2.78 ) after 6 months in group A were significantly higher than group B ( 73.23± 2.13 , 82.32± 2.27 , P <0.05).Axial compression and the failure load in group A were significantly higher than those in group B,and the torsional rigidity in group A was lower than in group B,the differences were statistically significant ( P < 0.05). Conclusion The proximal femoral anti rotation intramedullary nail is superior to the anatomical locking plate in the treatment of senile femoral intertrochanteric fracture.It can effectively promote the recovery of hip function and accelerate the healing of fracture.