空心钉辅助PFNA内固定治疗特殊类型股骨粗隆间骨折的疗效研究

Effect of hollow nail-assisted PFNA internal fixation in treating special type of intertrochanteric fracture of femur

目的:探讨应用空心钉辅助抗旋股骨近端髓内钉系统(proximal femoral nail antirotation,PFNA)内固定治疗骨折线波及股骨颈的股骨粗隆间骨折患者的疗效。方法:选取2015年1月至2018年5月在某院治疗的90例骨折线波及股骨颈的股骨粗隆间骨折患者作为研究对象,采用随机数表法分为平行组和干预组,每组各45例。平行组患者接受常规PFNA内固定术治疗,干预组患者接受空心钉辅助PFNA内固定术治疗。对比2组患者术中情况、术后疗效及术后并发症发生情况。采用SPSS 20.0软件对数据进行处理。结果:干预组患者手术时间长于平行组(P<0.01),2组出血量比较差异无统计学意义(P>0.05),但干预组患者术后卧床时间、骨折愈合时间明显缩短(P<0.05);干预组患者术后3个月、6个月、12个月的Harris评分均明显优于平行组(P<0.05);干预组患者并发症发生率为2.22%,明显少于平行组的17.78%(P<0.05)。结论:采用空心钉辅助PFNA内固定术治疗骨折线波及股骨颈的股骨粗隆间骨折患者疗效显著,可以显著缩短患者术后卧床时间和骨折愈合时间、提高患者Harris评分、减少各类并发症的发生,值得在临床推广应用。

Objective To observe the effect of using hollow nail-assisted PFNA to treat patients with intertrochanteric fracture of femur with fracture line affecting femoral neck.Methods Totally 90 patients surfing from intertrochanteric fracture of femur with fracture line affecting femoral neck were selected and assigned into a parallel group(n=45)and an intervention group(n=45)with a random number table from January 2015 to May 2018.The patients in the parallel group were treated with conventional PFNA internal fixation and the ones in the intervention group were provided with hollow nail-assisted PFNA internal fixation.The intraoperative conditions,postoperative efficacy and postoperative complications of the patients in the two groups were compared.SPSS 20.0 software was used for data processing.Results The operation time of the intervention group was longer than that of the parallel group(P<0.01),and there was no significant difference in the amounts of bleeding between the two groups(P>0.05),while the patients in the intervention group had a significantly shorter postoperative bed rest and fracture healing time(P<0.05);Harris scores of the patients in the intervention group were significantly higher than those in the parallel group at 3,6 and 12 months after surgery(P<0.05);the incidence of complications in the intervention group was 2.22%,which was significantly lower than that in the parallel group(17.78%)(P<0.05).Conclusion The hollow nail-assisted PFNA for the treatment of intertrochanteric fractures with the fracture line affecting the femoral neck is effective in significantly shortening the postoperative bed rest and fracture healing time,improving Harris score and reducing the occurrence of various complications,and is worthy promoting in clinical practice.