术前精准测量应用于股骨粗隆间骨折患者PFNA术中的效果分析

Analysis of the Effect of Preoperative Precise Measurement in PFNA for Patients with Intertrochanteric Fracture of Femur

目的:探讨术前精准测量应用于股骨粗隆间骨折患者骨近端防旋髓内钉(PFNA)术中的临床价值。方法:选取2016年1月-2018年1月本院收治的股骨粗隆间骨折患者80例,根据随机数x表法分为对照组和观察组,每组40例。对照组术前不行精准测量,观察组术前行精准测量。术后随访1年,比较两组术中X线透视次数、手术时间、术中出血量、螺钉尖顶距,髋关节Harris评分(疼痛、功能、关节活动度、肢体畸形),颈干角(NSA)、头颈轴长(NLA)及术后并发症发生情况。结果:观察组患者术中X线透视次数、术中出血量均少于对照组,手术时间短于对照组,差异均有统计学意义(P<0.05),两组螺钉尖顶距比较,差异无统计学意义(P>0.05)。术后1年,两组疼痛、功能、关节活动度、肢体畸形等各项Harris评分比较,差异均无统计学意义(P>0.05)。两组术后即刻、6个月、12个月NSA、NLA水平比较,差异均无统计学意义(P>0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:股骨粗隆间骨折患者行PFNA术前进行精准测量可减少术中X线透视次数、术中出血量,缩短手术时间,且安全有效。

Objective:To explore the clinical value of preoperative precise measurement in the operation of proximal femoral nail antirotation (PFNA) in patients with intertrochanteric fracture of femur.Method:A total of 80 patients with intertrochanteric fracture of femur admitted to our hospital from January 2016 to January 2018 were selected.According to the random number method,the patients were divided into control group and observation group,40 cases in each group.The control group could not measure accurately before operation,the observation group was measured accurately before operation.The patients were followed up for 1 year,the X-ray fluoroscopy times,operation time,intraoperative bleeding volume,screw apex distance,Harris score of hip joint (pain,function,joint mobility,limb deformity),neck stem angle (NSA),head and neck axis length (NLA) and postoperative complications were compared between the two groups.Result:The times of X-ray fluoroscopy and the amount of bleeding in the observation group were less than those in the control group,the operation time was shorter than that of the control group,the difference were statistically significant (P<0.05).The screw apex distance between two groups was compared,there was no significant difference (P>0.05).One year after operation,the Harris scores of pain,function,joint activity and limb deformity between the two groups were compared,there were no significant differences (P>0.05).The NSA and NLA levels of the two groups were compared immediately,6 and 12 months after operation,there were no significant differences (P>0.05).The incidence of postoperative complications was compared between the two groups,there was no significant differences (P>0.05).Conclusion:Preoperative prescise measurement of PFNA in patients with intertrochanteric fracture of femur can reduce the times of X-ray fluoroscopy and the amount of bleeding during operation,shorten the operation time,and is safe and effective.