人工关节置换术与防旋股骨近端髓内钉内固定治疗股骨转子间骨折的效果比较

Comparison the Effect of Artificial Joint Replacement and Proximal Femoral Nail Anti-rotation Internal Fixation in the Treatment of Intertrochanteric Fractures

目的比较人工关节置换术与防旋股骨近端髓内钉内固定治疗股骨转子间骨折的效果。方法随机选取2019年1月至2020年1月于我院接受治疗的88例股骨转子间骨折患者作为研究对象,根据1∶1分组原则将其分为试验组和对照组,每组44例。试验组采用防旋股骨近端髓内钉内固定治疗,对照组采用人工髋关节置换术治疗。比较两组手术相关指标、治疗效果及并发症发生情况。结果试验组术中出血量少于对照组,手术时间、住院时间短于对照组,差异均有统计学意义(均P<0.05);试验组治疗优良率高于对照组,差异有统计学意义(P<0.05);试验组治疗后的疼痛评分低于对照组,髋关节功能评分高于对照组,负重时间、骨折愈合时间短于对照组,差异均有统计学意义(均P<0.05);试验组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论防旋股骨近端髓内钉内固定治疗股骨转子间骨折的效果和安全性优于人工关节置换术,其手术时间、住院时间、负重时间、骨折愈合时间均较短,且患者疼痛程度轻微,髋关节功能恢复良好,术后并发症少。

Objective To compare the effect of artificial joint replacement and proximal femoral nail anti-rotation internal fixation in the treatment of intertrochanteric fractures.Methods A total of 88 patients with intertrochanteric femoral fractures treated in our hospital from January 2019 to January 2020 were randomly selected as the research object,and they were divided into an experimental group and a control group according to the 1∶1 grouping principle,44 cases in each group.The experimental group was treated with proximal femoral nail anti-rotation internal fixation,and the control group was treated with artificial hip replacement.The operation-related indexes,effects of treatment and complications of the two groups were compared.Results The intraoperative blood loss in the experimental group was less than that in the control group,and the operation time and hospitalization time were shorter than the control group,the differences were statistically significant(all P<0.05).The excellent rate of treatment in the experimental group was higher than that in the control group,the difference was statistically significant(P<0.05).The pain score of the experimental group after treatment was lower than that of the control group,and the hip joint function score was higher than that of the control group,the differences were statistically significant(all P<0.05).The incidence of complications in the experimental group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The anti-rotation proximal femoral intramedullary nail fixation is more effective and safer than femoral intertrochanteric fractures in terms of operation time,hospitalization time,weight bearing time,and fracture healing time,and the patient’s pain level mild,with good hip function recovery and few postoperative complications.