微创锁定加压钢板联合髓内钉治疗老年股骨骨折疗效观察

Curative effect of minimally invasive locking compression plate combined with intramedullary nail in the treatment of senile femoral fracture

目的探讨微创锁定加压钢板联合髓内钉治疗老年股骨骨折的临床疗效。方法选取武汉科技大学附属汉阳医院自2016年1月至2017年6月收治的99例老年股骨近端骨折的患者为研究对象,根据治疗方式分为髓内钉组(n=48)与联合组(n=51)。比较术后两组患者的视觉疼痛模拟评分(VAS)、Harris评分、骨折愈合率、骨折愈合时间及并发症发生率。结果术后2周,两组患者疼痛VAS评分比较,差异无统计学意义(P>0.05)。两组患者术后12个月的髋关节Harris评分显著高于术后6个月,差异有统计学意义(P<0.05);但两组间比较,差异无统计学意义(P>0.05)。联合组患者骨折愈合时间明显短于髓内钉组;联合组患者术后6、12个月骨折愈合率分别为84.3%(43/51)和100.0%(51/51),显著高于髓内钉组的79.2%(38/48)、95.8%(46/48),差异有统计学意义(P<0.05)。髓内钉组的并发症发生率为14.6%(7/48),高于联合组的9.8%(5/51),差异有统计学意义(P<0.05)。结论微创锁定加压钢板联合髓内钉治疗老年股骨近端骨折愈合时间短,愈合率高,并发症少,临床效果显著。

Objective To investigate the clinical efficacy of minimally invasive locking compression plate combined with intramedullary nail in the treatment of femoral fracture in the elderly.Methods A retrospective study was performed on 99 cases of elderly patients with proximal femur fracture who were admitted from January 2016 to June 2017.According to different treatments,patients were divided into the intramedullary nail group(n=48)and combined nail group(n=51).Pain visual analogue scale(VAS),Harris score,fracture healing rate,fracture healing time and complication rate were compared between the two groups.Results Two weeks after surgery,the VAS scores of patients in both groups were significantly reduced,with no statistical significance(P>0.05).The Harris score of the hip joint of the two groups 12 months after the operation was significantly higher than that of the hip joint of the two groups 6 months after the operation(P<0.05).There was no significant difference between the two groups(P>0.05).The fracture healing time of the combined group was significantly shorter than that of the intramedullary nail group.The fracture healing rates of the combined group were 84.3%(43/51)and 100.0%(51/51)at 6 and 12 months after the operation,which were significantly higher than 79.2%(38/48)and 95.8%(46/48)in the intramedullary nail group(P<0.05).The complication rate of intramedullary nail group was 14.6%(7/48).The complication rate was 9.8%(5/51)higher than that of the combined group(P<0.05).Conclusion The clinical effect of the minimally invasive locking compression plate in the treatment of femoral fracture is significant.The fracture healing time is fast with the high healing rate and the complications are few,with significant clinical effect.