影响PFNA治疗股骨粗隆间骨折疗效相关因素分析

Analysis of Factors Related to the Efficacy of PFNA in the Treatment of Intertrochanteric Fractures

目的探究影响股骨近端抗旋髓内钉(proximal femoral nail antirota-tion,PFNA)治疗股骨粗隆间骨折疗效相关因素分析。方法纳入包头医学院第三附属医院骨科2012年12月—2016年12月收入股骨粗隆间骨折患者共计48例,分析上述患者一般资料及术后恢复情况,采取Logistic回归方程计算影响疗效相关因素。结果年龄、股骨粗隆间骨折Evans-Jensen分类、术中颈干角恢复与否、术中前倾角恢复与否、近端内侧壁骨块复位与否、骨折愈合时间,差异有统计学意义(χ^2=12.579、24.382、12.673、8.224、2.409,P<0.05),差异项目带入Logistic回归方程计算,年龄、股骨粗隆间骨折Evans-Jensen分类、术中颈干角恢复与否、术中前倾角恢复与否、近端内侧壁骨块复位与否、骨折愈合时间均为影响患者疗效影响因素,差异有统计学意义(SE=0.084、0.030、0.039、0.029、0.029、0.132,P<0.05)。结论年龄、股骨粗隆间骨折Evans-Jensen分类、术中颈干角恢复与否、术中前倾角恢复与否、近端内侧壁骨块复位与否、骨折愈合时间为影响PFNA治疗疗效因素,临床医师应做好防护工作,降低人为因素干预,提高骨折愈合整体效果。

Objective To investigate the factors affecting the treatment of intertrochanteric fractures of the femur with proximal femoral nail antirota-tion(PFNA). Methods A total of 48 patients with intertrochanteric fractures from December 2012 to December 2016 were enrolled in the Department of Orthopaedics, the Third Affiliated Hospital of Baotou Medical College. The general data and postoperative recovery were analyzed. Logistic regression equation was used to calculate the factors affecting the efficacy. Results Age, femoral intertrochanteric fracture Evans-Jensen classification, intraoperative neck dry angle recovery or not, intraoperative anteversion angle recovery, proximal end wall bone block reduction or not, fracture healing time differencethe difference was statistically significant(χ^2=12.579,24.382,12.673,8.224,2.409, P<0.05), the difference items were entered into the logistic regression equation, age, femoral intertrochanteric fracture Evans-Jensen classification, intraoperative neck dry angle recovery or not, intraoperative anteversion recovery or not, the reduction of the proximal end wall bone block and the fracture healing time were all factors affecting the patient’s efficacythe difference was statistically significant(SE =0.084, 0.030, 0.039, 0.029, 0.029,0.132, P<0.05). Conclusion Age, intertrochanteric fracture Evans-Jensen classification, intraoperative neck dry angle recovery, intraoperative anteversion angle recovery, proximal end wall bone block reduction or fracture healing time is a factor influencing PFNA treatment. Clinicians should do a good job of prevention, reduce human intervention,and improve the overall effect of fracture healing.