两种不同方式治疗稳定性股骨转子间骨折的效果分析

Analysis of the effects of two different methods in the treatment of stable intertrochanteric fractures

目的探讨股骨近端防旋髓内钉内固定和经皮加压钢板内固定两种手术方式在治疗稳定性股骨转子间骨折的效果。方法选取2017年1月~2019年12月在内蒙古林业总医院骨科住院并手术的稳定性股骨转子间骨折的患者70例,分为经皮加压钢板内固定(A组)38例和股骨近端防旋髓内钉内固定(B组)32例。并记录两组患者手术时间和手术过程中的出血量,根据骨折线愈合情况记录患者下地负重时间或骨折愈合时间,且分别在术后1、3及6个月使用Harris评分系统对患者恢复功能进行评估,观察患者在术后6个月内并发症如泌尿系感染、肺部感染、压疮以及深静脉血栓的发生情况。结果两组患者手术时间比较,差异无统计学意义(P>0.05);A组患者出血量显著低于B组(P<0.05);两组患者在术后1个月及术后3个月Harris评分比较,差异无统计学意义(P>0.05);B组患者术后6个月Harris评分高于A组(P<0.05);而B组下地负重时间与骨折愈合时间患者明显短于A组(P<0.001);两组患者并发症比较,差异无统计学意义(P>0.05)。结论近端防旋髓内钉在治疗稳定性股骨转子间骨折更具有优势。

Objective To explore the effect of proximal femoral nail anti-rotation(PFNA)and percutaneous compression plate(PCCP)in the treatment of stable intertrochanteric fractures.Methods A total of 70 patients with stable intertrochanteric fractures who were hospitalized and operated in the department of orthopedics in our hospital from January 2017 to December 2019 were collected and divided into group A(n=38)and group B(n=32).Group A was treated with PCCP,while group B was treated with PFNA.The operation time and blood loss during operation were recorded.According to the healing condition of fracture line,the weight bearing time or fracture healing time of patients were recorded.Harris scoring system was used to evaluate the functional rehabilitation of patients at 1 month,3 months and 6 months after operation.Changes in complications such as urinary tract infection,pulmonary infection,pressure sores,and deep venous thrombosis were observed in patients within 6 months after operation.Results There was no difference in operation time between the two groups(P>0.05).The blood loss in group A was significantly lower than that in group B(P<0.05).There was no difference in Harris scores between the two groups 1 month and 3 months after operation(P>0.05).Harris score 6 months after operation was higher in group B than in group A(P<0.05).Weight bearing time and fracture healing time were significantly lower in group B than in group A(P<0.001).There was no significant difference in complications between the two groups(P>0.05).Conclusion PFNA has more advantages in the treatment of stable inter-trochanteric fractures.