两种体位下PFNA内固定治疗不稳定型股骨粗隆间骨折的效果比较分析

Comparison of PFNA internal fixation under two different positions in treatment of unstable femoral intertrochanteric fracture

目的探讨侧卧位、仰卧位下防旋股骨近端髓内钉(proximal femoral nail antirotation,PFNA)内固定术在不稳定型股骨粗隆间骨折患者中的应用效果。方法回顾性分析2016年1月至2018年9月在本院接受PFNA内固定治疗的92例不稳定型股骨粗隆间骨折患者的临床资料,依据术中体位的不同,分为观察组(侧卧位,46例)与对照组(仰卧位,46例),比较两组围术期临床指标、髋关节功能。结果两组骨折愈合时间、髋关节功能评分、并发症发生率对比,差异无统计学意义;观察组切口长度、手术时间、术后下床活动时间均短于对照组,术中X线透视剂量少于对照组,差异有统计学意义(P<0.05)。结论于侧卧位、仰卧位下对不稳定型股骨粗隆间骨折患者进行PFNA内固定术治疗,均可改善患者髋关节功能,但前者可进一步缩小切口长度,加快术后康复速度。

Objective To investigate the application effects of proximal femoral nail antirotation (PFNA) internal fixation under lateral position and supine position in patients with unstable femoral intertrochanteric fracture. Methods The clinical data of 92 patients with unstable femoral intertrochanteric fracture treated with PFNA internal fixation in the hospital from January 2016 to September 2018 were retrospectively analyzed. They were divided into observation group (lateral position, 46 cases) and control group (supine position, 46 cases) according to surgical positions. The perioperative clinical indexes and hip joint function were compared between the two groups. Results There was no statistical difference in the fracture healing time, score of hip joint function, incidence of complications between the two groups;The length of incision, operation time and postoperative off-bed activity time in observation group were shorter than those in control group, and the intraoperative X-ray fluoroscopy dose in observation group was less than that in control group (P<0.05). Conclusion PFNA internal fixation under lateral position and supine position in treatment of patients with unstable femoral intertrochanteric fracture can improve hip joint function, but the former can further reduce the length of incision, and accelerate postoperative recovery.