防旋髓内钉和动力髋螺钉治疗股骨粗隆间骨折的临床研究

Clinical study on the treatment of intertrochanteric fracture of femur with antirotation intramedullary nail and dynamic hip screw

目的探究防旋髓内钉和动力髋螺钉治疗股骨粗隆间骨折的临床疗效。方法选取2017年1月至2019年7月在本院就诊的60例股骨粗隆间骨折患者,依据入院时间先后顺序分为观察组与对照组,各30例。对照组使用动力髋螺钉进行治疗,观察组使用防旋髓内钉进行治疗,观察对比两组治疗效果。结果两组患者手术时间、切口长度、出血量比较差异有统计学意义(P<0.05),且观察组均优于对照组(P<0.05);对照组25例,观察组23例获得随访,骨折已全部愈合。观察组愈合速度快于对照组,两组平均愈合时间比较差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组髋关节功能Harris评分优良率优于对照组,差异有统计学意义(P<0.05);治疗前,两组患者VAS指标比较差异无统计学意义,治疗后,观察组各项指标改善均优于对照组(P<0.05)。结论采取防旋髓内钉治疗股骨粗隆间骨折患者能有效提高临床疗效,术中创口小,术后恢复快,且安全性较高,值得临床推广。

Objective To investigate the clinical effect of anti-rotation intramedullary nail and dynamic hip screw in the treatment of intertrochanteric fracture of femur.Methods 60 patients with intertrochanteric fracture admitted to our hospital from January 2017 to July 2019 were selected and they were divided into observation group and control group according to the order of admission time,with 30 cases in each group.The control group was treated with dynamic hip screw,while the observation group was treated with anti-rotation intramedullary nail,and the therapeutic effects were observed and compared between the two groups.Results There was statistically significant difference in operation time,incision length and blood loss between the two groups(P<0.05),and the observation group was better than the control group(P<0.05).25 cases in the control group and 23 cases in the observation group were followed up,and all fractures had healed.The healing speed of the observation group was faster than that of the control group,and the difference of the average healing time between the two groups was statistically significant(P<0.05).The complication rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).The excellent and good Harris score of hip joint function in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in VAS index between the two groups.After treatment,the improvement of all indicators in the observation group was better than that in the control group(P<0.05).Conclusion The treatment of intertrochanteric fracture with anti-rotation intramedullary nail can effectively improve the clinical efficacy of patients with small intraoperative incision,quick postoperative recovery,and high safety,which is worthy of clinical promotion.