PFNA与近端解剖锁定钢板治疗老年股骨近端骨折的效果研究

Efficacy analysis of PFNA and proximal anatomical locking plate in the treatment of elderly proximal femoral fractures

目的探讨股骨近端防旋髓内钉(PFNA)内固定与近端解剖锁定钢板治疗老年股骨近端骨折的效果及对患者预后恢复、心理状况的影响。方法选择我院收治的老年股骨近端骨折患者300例,随机分为对照组和观察组,对照组147例行近端解剖锁定钢板手术治疗,观察组153例行PFNA手术治疗,观察两组患者的手术疗效及相关指标,同时对患者骨折愈合时间及预后进行评价。结果观察组在术中出血量、切口长度以及手术时间均占有明显优势,与对照组比较,P<0.05;观察组患者的临床效果优于对照组(P<0.05);术后随访12个月,观察组患者出院时间、负重行走时间以及骨折愈合时间均短于对照组,且SAS、SDS及ADL量表评分均优于对照组(P<0.05)。结论两种术式对于老年股骨近端骨折均有显著的治疗效果,PFNA内固定能够最大程度上降低患者的创伤,加速了术后骨折愈合的时间,缓解患者焦虑、紧张情绪。

Objective To explore the efficacy of proximal femoral nail antirotation(PFNA) and proximal anatomical locking plate in the treatment of elderly proximal femoral fractures, and their effect on prognosis and psychological status of patients. Methods A total of 300 elderly patients with proximal femoral fractures admitted to our hospital were enrolled and randomly divided into the observation group and the control group. 147 cases in the control group underwent proximal anatomical locking plate surgery and 153 cases in the observation group received PFNA surgery. The surgical efficacy and related indexes of the two groups were observed. The fracture healing time and prognosis were evaluated. Results The intraoperative blood loss, length of incision and operation time of the observation group were better than those of the control group(P<0.05). The clinical effect of the observation group was better than that of the control group(P<0.05). After 12 months of follow-up, the discharge time, weight walking time and fracture healing time of the observation group were shorter than those in the control group;the SAS, SDS and ADL scores in the observation group were better than those in the control(P<0.05). Conclusion The two surgical methods have significant therapeutic effects on elderly patients with proximal femoral fractures. PFNA surgery can minimize the trauma of surgery, accelerate the postoperative fracture healing and relieve their anxiety and nervousness.