动力髋螺钉与股骨近端抗旋髓内钉治疗外侧壁危险型股骨粗隆间骨折的临床对比研究

Clinical Comparative Study of Dynamic Hip Screw and Proximal Femoral Anti-rotating Intramedullary Nail in the Treatment of Risky Femoral Intertrochanteric Fractures of the Lateral Wall

目的对比使用动力髋螺钉与股骨近端抗旋髓内钉对外侧壁危险型股骨粗隆间骨折的治疗效果。方法将该院2017年6月-2018年7月收治的85例研究对象随机分成观察组(43例)与对照组(42例),对照组使用传统动力髋螺钉治疗,观察者使用股骨近端抗旋髓内钉治疗,观察两组治疗效果。结果观察组切口长度、手术时间、骨折愈合时间及住院时间分别为(4.87±1.39)d、(70.23±8.87)min、(12.26±2.67)d、(10.87±2.74)d,对照组对应指标别为(9.52±2.27)d、(84.46±9.64)min、(15.57±3.19)d、(14.48±3.36)d,两组对比差异有统计学意义(t=11.419、7.085、5.192、5.434,P=0.000、0.000、0.000、0.000);随访半年显示观察者患者髋关节功能优良率为93.02%,明显高于对照组76.19%的优良率(χ^2=4.647,P=0.031);观察组术后并发症发生率为4.65%,明显低于对照组19.05%的发生率(χ^2=4.242,P=0.039)。结论针对外侧壁危险型股骨粗隆间骨折,采用股骨近端抗旋髓内钉治疗可获得显著疗效,促进患者髋功能尽早康复及降低术后并发症,值得推广。

Objective To compare the therapeutic effects of dynamic hip screw and proximal femoral anti-spinning nail in the treatment of external femoral intertrochanteric fractures.Methods Eighty-five subjects admitted to the hospital from June 2017 to July 2018 were randomly assigned to an observation group(43 patients)and a control group(42 patients).The control group was treated with conventional dynamic hip screw,and the observation group used a proximal femur end-to-endocardial nail treatment,the effect of the two groups was observed.Results The incision length,operation time,fracture healing time and hospitalization time were(4.87±1.39)d,(70.23±8.87)min,(12.26±2.67)d,(10.87±2.74)d,respectively.And the control group of(9.52±2.27)d,(84.46±9.64)min,(15.57±3.19)d,(14.48±3.36)d,the difference between the two groups was statistically significant(t=11.419,7.085,5.192,5.434,P=0.000,0.000,0.000,0.000);the excellent rate of hip function was 93.02%in the follow-up period,which was significantly higher than the 76.19%in the control group(χ^2=4.647,P=0.031).The incidence rate was 4.65%,which was significantly lower than the incidence of 19.05%in the control group(χ^2=4.242,P=0.039).Conclusion For the treatment of external femoral intertrochanteric fractures,the use of proximal femoral anti-rotating intramedullary nail can achieve significant effect,promote early recovery of hip function and reduce postoperative complications.It is worth promoting.