比较动力髋螺钉与防旋股骨近端髓内钉治疗外侧壁危险型股骨粗隆间骨折的临床效果

Comparison of the Clinical Effects of Dynamic Hip Screw and Anti-rotation Proximal Femoral Nail in the Treatment of Dangerous Intertrochanteric Femoral Fractures of the Lateral Wall

目的对比研究外侧壁危险型股骨粗隆间骨折患者采用防旋股骨近端髓内钉与动力髋螺钉两种技术实施手术治疗的临床效果。方法选择2017年8月—2019年8月在该院接受手术治疗的60例外侧壁危险型股骨粗隆间骨折患者,利用随机数字表法将研究对象分成对照组和治疗组,每组30例。对照组采用动力髋螺钉技术实施手术治疗;治疗组采用防旋股骨近端髓内钉技术实施手术治疗。对比手术治疗总有效率、手术操作时间、术后住院时间、术后髋关节功能恢复时间、操作期间出血量、术后引流量、切口长度、术后并发症情况、手术治疗前后髋关节功能Harris评分、疼痛程度VAS评分、生活质量SF-36量表评分、对治疗方案及效果的满意度。结果治疗组患者手术治疗总有效率达到93.3%,对照组的治疗总有效率为70.0%,两组对比差异有统计学意义(χ^(2)=5.455,P<0.05);治疗组患者的术后住院时间、手术操作时间、术后髋关节功能恢复时间较对照组明显缩短;操作期间出血量、术后引流量、切口长度低于对照组;术后并发症仅有1例,少于对照组的6例;手术治疗前后,患者疼痛程度VAS评分、髋关节功能Harris评分、生活质量SF-36量表评分水平的改善幅度大于对照组;对骨折治疗方案及效果的满意度达到96.7%,高于对照组的73.3%。组间对比差异有统计学意义(χ^(2)=4.706,P<0.05)。结论外侧壁危险型股骨粗隆间骨折患者采用防旋股骨近端髓内钉技术实施手术治疗,能够减小手术操作切口长度,对出血量、术后引流量进行有效控制,降低术后并发症发生率,手术操作时间、术后恢复时间均得到显著缩短,在短时间内减轻疼痛,大幅度改善髋关节功能和生活质量,使治疗总有效和患者满意度显著提高。

Objective To compare the clinical effects of surgical treatment of patients with dangerous lateral femoral intertrochanteric fractures using anti-rotation proximal femoral nail and dynamic hip screw.Methods Selected 60 patients with sidewall dangerous intertrochanteric fractures who underwent surgical treatment in the hospital from August 2017 to August 2019.The study subjects were divided into a control group and a treatment group using a random number table method,30 cases in each group,the control group was treated with dynamic hip screw technique;the treatment group was treated with anti-rotation proximal femoral nail technique.Compared the total effective rate of surgical treatment,surgical operation time,postoperative hospital stay,postoperative hip function recovery time,blood loss during operation,postoperative drainage,incision length,postoperative complications,and hip function before and after surgical treatment Harris Score,pain degree VAS score,quality of life SF-36 scale score,satisfaction with treatment plan and effect.Results The total effective rate of surgical treatment in the treatment group reached 93.3%,and the total effective rate of the treatment in the control group was 70.0%.The difference between the two groups was statistically significant(χ^(2)=5.455,P<0.05);the postoperative hospital stay of the patients,the operation time and postoperative hip function recovery time in the treatment group were significantly shorter than those in the control group;the amount of bleeding,postoperative drainage,and incision length during the operation were lower than those in the control group;postoperative complications were only 1 case,which was less 6 cases;before and after surgical treatment,the patients'pain degree VAS score,hip joint function Harris score,and quality of life SF-36 scale score improved more than the control group;the satisfaction with fracture treatment plan and effect reached 96.7%,which was higher than that 73.3%of the control group.The difference was statistical significance between the groups(χ^(2)=4.706,P<0.05).Conclusion In patients with dangerous lateral femoral intertrochanteric fractures,surgical treatment with anti-rotation proximal femoral nail technology can reduce the length of the surgical incision,effectively control the amount of bleeding and postoperative drainage,and reduce postoperative complications incidence of symptoms,operation time,and postoperative recovery time have been significantly shortened,pain will be reduced in a short time,hip joint function and quality of life will be greatly improved,the overall effectiveness of treatment and patient satisfaction will be significantly improved.