股骨近端防旋髓内钉与动力髋螺钉对老年创伤性股骨粗隆间骨折的效果观察

Observation Effect of Anti-rotation Proximal Femoral Intramedullary Nail and Dynamic Hip Screw on Elderly Traumatic Intertrochanteric Fractures

目的观察股骨近端防旋髓内钉与动力髋螺钉治疗老年创伤性股骨粗隆间骨折效果、术后功能以及并发症发生情况。方法选取2015年10月~2019年9月在我院治疗的220例老年创伤性股骨粗隆间骨折患者为研究对象,采用随机数字表法分为对照组和研究组,各110例。对照组采用动力髋螺钉治疗,研究组采用股骨近端防旋髓内钉治疗,比较两组临床治疗效果、手术指标、髋关节功能评分(Harris评分)、并发症发生情况以及骨折复位丢失率。结果研究组优良率(93.63%)高于对照组(90.00%),但差异无统计学意义(P>0.05);研究组手术时间、术中出血量以及骨折愈合时间均小于对照组,差异有统计学意义(P<0.05);治疗后,研究组Harris评分为(88.11±4.78)分,高于对照组的(71.84±6.20)分,差异有统计学意义(P<0.05);研究组并发症发生率(3.63%)与对照组(4.54%)比较,差异无统计学意义(P>0.05),研究组骨折复位丢失率(10.91%)低于对照组(22.72%),差异有统计学意义(P<0.05)。结论股骨近端防旋髓内钉与动力髋螺钉治疗老年创伤性股骨粗隆间骨折均具有良好的治疗效果,且安全性良好。但股骨近端防旋髓内钉手术时间更短、术中出血量更少,Harris评分更高,且骨折复位丢失率较低,利于患者的术后恢复,值得临床应用。

Objective To observe the effect of proximal femoral anti-rotation intramedullary nail and dynamic hip screw in the treatment of elderly traumatic femoral intertrochanteric fractures,postoperative function and complications.Methods A total of 220 elderly patients with traumatic intertrochanteric fractures of the femur who were treated in our hospital from October 2015 to September 2019 were selected as the research objects.They were divided into a control group and a study group by a random number table,with 110 cases in each group.The control group was treated with dynamic hip screws,and the study group was treated with proximal femur anti-rotation intramedullary nails.The clinical treatment effects,surgical indicators,hip function scores(Harris scores),complications,and fracture reduction loss rates were compared between the two groups.Results The excellent and good rate of the study group(93.63%)was higher than that of the control group(90.00%),but the difference was not statistically significant(P>0.05);the operation time,intraoperative blood loss,and fracture healing time of the study group were lower than those of the control group,the difference was statistically significant(P<0.05);After treatment,the Harris score of the study group was(88.11±4.78)points,which was higher than the control group(71.84±6.20)points,the difference was statistically significant(P<0.05);the study group had complications incidence rate(3.63%)compared with the control group(4.54%),the difference was not statistically significant(P>0.05),the fracture reduction loss rate of the study group(10.91%)was lower than the control group(22.72%),the difference was statistically significant(P<0.05).Conclusion Proximal femoral anti-rotation intramedullary nail and dynamic hip screw for the treatment of elderly traumatic femoral intertrochanteric fractures have good therapeutic effects and good safety.However,the proximal femoral nail anti-rotation intramedullary nail has shorter operation time,less intraoperative blood loss,higher Harris score,and lower fracture reduction loss rate,which is conducive to the postoperative recovery of patients and is worthy of clinical application.