仰卧位牵引床与侧卧位非牵引床PFNA对外侧壁完整股骨粗隆间骨折患者的近期疗效分析

Analysis of the short-term therapeutic effect of PFNA with supine traction bed and lateral non-traction bed in patients with intertrochanteric fractures with intact external lateral wall

目的:比较仰卧位牵引床与侧卧位非牵引床股骨近端防旋髓内钉(PFNA)对外侧壁完整股骨粗隆间骨折患者的近期疗效。方法:选择2017年1月至2019年8月我院的62例外侧壁完整股骨粗隆间骨折患者,根据随机数字表法分为对照组和观察组两组。对照组采用仰卧位牵引床PFNA治疗,观察组采用侧卧位非牵引床PFNA治疗。比较两组的切口长度、手术时间、术后愈合时间、术中出血量和并发症(内固定切出、髋内翻、骨不愈合、退钉现象)发生率。结果:观察组的手术时间、切口长度和术中出血量明显低于对照组(P<0.05),两组的术后愈合时间无明显差异(P>0.05);观察组的内固定切出、髋内翻、骨不愈合、退钉现象发生率为9.68%(3/31),与对照组的12.90%(4/31)相比无明显差异(P>0.05);两组的Harris髋关节功能评分无明显差异(P>0.05)。结论:仰卧位牵引床与侧卧位非牵引床PFNA对外侧壁完整股骨粗隆间骨折患者均能取得较好的疗效,但是仰卧位牵引床相比,侧卧位非牵引床PFNA的出血更少,创伤更小,手术操作更加简便,值得进行推广。

Objective:To compare the short-term outcomes of PFNA with supine traction bed and lateral non-traction bed in patients with intertrochanteric fractures with intact external lateral wall.Methods:Sixty-two patients with complete lateral wall intertrochanteric fracture from January 2017 to August 2019 were selected and divided into control group and observation group according to random number table method.The control group was treated with supine traction bed PFNA,and the observation group was treated with lateral decubitus non-traction bed PFNA.The incision length,operative time,postoperative healing time,intraoperative blood loss and the incidence of complications(internal fixation and extirpation,hip varus,bone nonunion,and nail withdrawal)were compared between the two groups.Results:The operation time,incision length and intraoperative blood loss in the observation group were significantly lower than those in the control group(P<0.05),and there was no significant difference in postoperative healing time between the two groups(P>0.05).The incidence of internal fixation,hip varus,nonunion,and nail withdrawal in the observation group was 9.68%(3/31),which was not significantly different from the control group's 12.90%(4/31)(P>0.05).There was no significant difference in Harris hip function score between the two groups(P>0.05).Conclusion:PFNA in supine traction bed and lateral non-traction bed can achieve better results in the treatment of femoral intertrochanteric fracture.However,compared with that in supine traction bed,PFNA in lateral non-traction bed has less bleeding,less trauma,and more simple operation,which is worth promoting.