评价老年股骨粗隆间骨折患者使用防旋髓内钉(PFNA)与解剖型锁定钢板(ALP)内固定手术的临床价值

To Evaluate the Clinical Value of Anti-rotation Intramedullary Nail(PFNA) and Anatomical Locking Plate(ALP) Internal Fixation in Elderly Patients with Intertrochanteric Fracture of Femur

目的比较老年股骨粗隆间骨折患者使用防旋髓内钉(PFNA)与解剖型锁定钢板(ALP)内固定手术的效果。方法随机选择在该院接受治疗的50例股骨粗隆间骨折老年患者,治疗时间为2017年2月—2018年2月,采用双盲法将患者分为两组,观察组采用PFNA内固定治疗,对照组采用ALP内固定治疗。结果对照组有19例为优良,4例为较好,1例为尚可,1例为差,术后髋关节功能优良率为75%,观察组有24例为优良,1例为较好,0例为尚可,0例为差,术后髋关节功能优良率为96%,组间差异有统计学意义(χ^2=4.153,P<0.05)。观察组术中出血量(123.5±29.5)mL,对照组为(326.5±50.2)mL(t=17.4320,P=0.0000)。观察组骨折愈合时间(12.0±1.0)周,对照组为(16.4±1.1)周(t=14.7988,P=0.0000)。观察组手术时间(42.3±12.0)min,对照组为(85.6±15.8)min(t=10.9120,P=0.0000)。与对照组相比较,观察组手术时间短,术中出血量少,骨折愈合快,组间差异有统计学意义(P<0.05)。结论应用PFNA内固定治疗老年股骨粗隆间骨折的临床效果更优越,能够有效提高治疗的优良率,帮助患者尽快康复。

Objective To compare the effect of anti-rotation intramedullary nail (PFNA) and anatomical locking plate (ALP) internal fixation in elderly patients with intertrochanteric fracture of femur.Methods 50 elderly patients with femoral intertrochanteric fracture were randomly selected and treated in our hospital from February 2017 to February 2018.The patients were divided into two groups by double blind method.The observation group was treated with PFNA internal fixation and the control group was treated with ALP internal fixation.Results In the control group,there were 19 cases of good,4 cases of good,1 case of fair,1 case of poor,the excellent and good rate of postoperative hip joint function was 75%,and in the observation group,there were 24 cases of good,1 case of good,0 cases of fair,0 cases of bad,the excellent and good rate of postoperative hip joint function was 96%,with significant differences between the groups (χ^2=4.153,P<0.05).Intraoperative blood loss in the observation group (123.5±29.5) mL,control group (326.5± 50.2) mL,(t=17.432 0,P=0.000 0).The fracture healing time of the observation group was (12.0±1.0) weeks,and that of the control group was (16.4±1.1) weeks(t=14.798 8,P=0.000 0).The operative time (42.3±12.0) min in the observation group and (85.6±15.8) min in the control group (t=10.912 0,P=0.000 0) respectively.compared with the control group,the observation group had shorter operation time,less bleeding,faster fracture healing and significant difference between the two groups (P<0.05).Conclusion PFNA internal fixation is more effective in the treatment of intertrochanteric fracture of femur in the elderly,which can effectively improve the excellent rate of treatment and help patients recover as soon as possible.