股骨近端防旋髓内钉治疗高龄不稳定股骨粗隆间骨折的临床应用研究

Clinical Application Study of Anti-rotation Intramedullary Proximal Femur Nail in the Treatment of Unstable Intertrochanteric Fractures of the Elderly

目的探讨股骨近端防旋髓内钉治疗高龄不稳定股骨粗隆间骨折的临床效果。方法方便选取2016年1月—2018年1月该院收治的84例高龄不稳定股骨粗隆间骨折患者,随机分为两组,对照组进行锁定板系统治疗,研究组进行股骨近端防旋髓内钉治疗。比较两组患者并发症发生率、手术状况、Harris评分。结果研究组并发症发生率为7.1%低于对照组21.4%,差异有统计学意义(χ^(2)=5.821,P<0.05);研究组手术时间、术后引流、手术切口、手术出血量为(55.7±2.2)min、(24.9±6.1)mL、(4.4±0.6)cm、(50.4±20.4)mL、小于对照组(66.9±4.9)min、(55.9±9.2)mL、(6.9±1.0)cm、(110.4±25.4)cm,差异有统计学意义(t=13.514、18.200、13.893、11.936,P<0.05);研究组术后1个月、3个月Harris评分为(48.2±10.2)分、(63.6±9.5)分低于对照组(65.3±6.6)分、(78.4±8.4)分,差异有统计学意义(t=9.122、7.564,P<0.05);研究组术后6个月、12个月Harris评分为(82.4±8.2)分、(83.3±10.2)分与对照组(83.4±9.3)分、(86.9±9.2)分相比,两组差异无统计学意义(t=0.523、1.698,P>0.05)。结论对高龄不稳定股骨粗隆间骨折患者,进行股骨近端防旋髓内钉治疗,效果理想,可缩短手术时间,减少术后引流量、手术出血量,降低Harris评分。同时,该治疗方法可降低并发症发生率,安全性较高。所以,在高龄不稳定股骨粗隆间骨折患者临床治疗中,股骨近端防旋髓内钉治疗应进一步推广和应用。

Objective To investigate the clinical effect of anti-rotation proximal femur intramedullary nail in the treatment of unstable intertrochanteric fractures of the elderly.Methods A total of 84 elderly patients with unstable femoral intertrochanteric fractures admitted to the hospital from January 2016 to January 2018 were randomly divided into two groups.The control group was treated with locking plate system,and the study group was treated with anti-rotation of the proximal femur internal nail.The complication rate,surgical status and Harris score were compared between the two groups.Results The complication rate of the study group was 7.1%lower than that of the control group 21.4%,the difference was statistically significant(χ^(2)=5.821,P<0.05);the operation time,postoperative drainage,surgical incision,and surgical blood loss were(55.7±2.2)min,(24.9±6.1)mL,(4.4±0.6)cm,(50.4±20.4)mL,less than the control group(66.9±4.9)min,(55.9±9.2)mL,(6.9±1.0)cm,(110.4±25.4)cm,the difference was statistically significant(t=13.514,18.200,13.893,11.936,P<0.05);the Harris score of the study group was(48.2±10.2)points,(63.6±9.5)points lower than the control group(65.3±6.6)points(78.4±8.4)points at 1 month and 3 months after surgery,the difference was statistically significant(t=9.122,7.564,P<0.05);the Harris score of the study group was(82.4±8.2)points,(83.3±10.2)points and the control group(83.4±9.3)points,(86.9±9.2)points,there was no significant difference between the two groups(t=0.523,1.698,P>0.05).Conclusion For elderly patients with unstable intertrochanteric fractures,the treatment of proximal femur anti-rotation intramedullary nails is effective.It can shorten the operation time,reduce postoperative drainage,surgical bleeding,and reduce Harris score.At the same time,the treatment method can reduce the incidence of complications and is safer.Therefore,in the clinical treatment of elderly patients with unstable intertrochanteric fractures,the treatment of proximal femur anti-rotation intramedullary nails should be further promoted and applied.