标准骨水泥强化型股骨近端防旋髓内钉治疗老年骨质疏松性股骨粗隆间不稳定骨折的效果

Effect of standard cement-enhanced proximal femoral anti-rotation intramedullary nail in the treatment of unstable intertrochanteric fractures of the elderly with osteoporotic femur

目的观察标准骨水泥强化型股骨近端防旋髓内钉(PFNA)治疗老年骨质疏松性股骨粗隆间不稳定骨折的临床效果。方法抽取郑州市骨科医院2018年1月至2019年12月收治的老年骨质疏松性股骨粗隆间不稳定骨折患者60例,按随机数字表法分为参照组与观察组,每组30例。参照组采用PFNA治疗,观察组采用标准骨水泥强化型PFNA治疗,比较两组手术时间,术中出血量,术后早期下床活动时间骨性愈合时间,并发症发生情况及术后3、6个月随访髋关节功能(Harris)评分。结果观察组手术时间长于参照组,术后早期下床活动时间、骨性愈合时间短于参照组,差异有统计学意义(P<0.05)。观察组与参照组术中出血量比较,差异未见统计学意义(P>0.05);观察组术后并发症发生率低于参照组,差异有统计学意义(P<0.05);术后3个月随访,观察组Harris评分与参照组比较,差异未见统计学意义(P>0.05)。术后6个月随访,观察组Harris评分高于术后3个月随访,且高于参照组,差异有统计学意义(P<0.05)。结论老年骨质疏松性股骨粗隆间不稳定骨折临床手术治疗中,采用标准骨水泥强化型PFNA治疗方案,有利于促进患者术后早期恢复,缩短骨性愈合时间,减少并发症影响,提高髋关节功能,临床疗效显著。

Objective To observe the clinical effect of standard bone cement reinforced proximal femoral nail(PFNA)in the treatment of senile osteoporotic unstable intertrochanteric fracture.Methods Sixty cases of senile osteoporotic unstable intertrochanteric fracture were selected from January 2018 to December 2019 in Zhengzhou Orthopedic Hospital,and they were randomly divided into control group and observation group,each with 30 cases.The control group was treated with PFNA,the observation group was treated with standard bone cement reinforced PFNA,the operation time,intraoperative blood loss,early ambulation time,bone healing time,complications and Harris scores were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,and the time of movement and bone healing of the observation group was shorter than that of the control group(P<0.05).There was no significant difference in the amount of intraoperative bleeding between the observation group and the control group(P>0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05),and there was no significant difference in Harris score between the observation group and the control group(P>0.05).After 6 months of follow-up,the Harris score in the observation group was higher than that in the 3 months follow-up group and higher than that in the control group(P<0.05).Conclusions In the clinical treatment of senile osteoporotic intertrochanteric unstable fracture,the adoption of the standard PFNA reinforced with bone cement can promote the patients'early recovery,shorten the bone healing time and reduce the influence of complications,improve the function of hip joint,the clinical curative effect is remarkable.