经皮撬拨与PFNA治疗老年骨质疏松性股骨粗隆间骨折效果

Effect of percutaneous prying and PFNA on intertrochanteric fracture of osteoporotic femur in elderly patients

目的:探讨经皮撬拨与股骨近端防旋髓内钉(PFNA)治疗老年骨质疏松性股骨粗隆间骨折的效果。方法:选取我院手术治疗的90例老年骨质疏松性股骨粗隆间骨折患者进行回顾性分析,其中50例患者采用经皮撬拨联合PFNA治疗(观察组)、另外44例患者采用切开复位下PFNA治疗(对照组);对比两组的手术操作指标、骨折愈合情况、术后髋关节功能恢复及手术并发症率。结果:观察组患者的手术时间、切口长度、手术出血量、住院时间均低于对照组(P<0.05);观察组和对照组的骨折愈合时间差异无统计学意义(P>0.05);术后3个月,观察组患者的髋关节Harris评分高于对照组(P<0.05);术后6个月,观察组和对照组的髋关节Harris评分差异无统计学意义(P>0.05);术后3个月,观察组患者的髋关节活动度大于对照组(P<0.05);术后6个月,观察组和对照组的髋关节活动度差异无统计学意义(P>0.05);观察组患者的手术并发症率4.00%低于对照组的17.50%,差异具有统计学意义(P<0.05)。结论:经皮撬拨与PFNA治疗老年骨质疏松性股骨粗隆间骨折较切开复位PFNA具有手术创伤小、术后可早期功能锻炼促进髋关节功能恢复、手术并发症率更低的优势。

Objective:To explore the effect of percutaneous prying and proximal anti-rotation intramedullary nail(PFNA)in the treatment of osteoporotic intertrochanteric fractures in the elderly.Methods:A retrospective analysis of 90 elderly patients with osteoporotic intertrochanteric fractures treated in our hospital was performed.Among them,50 patients were treated with percutaneous prying combined with PFNA(observation group),and 44 patients were treated with open reduction PFNA treatment(control group);compare the operation index,fracture healing status,postoperative hip joint function recovery and surgical complication rate of the two groups.Results:The operation time,incision length,operation bleeding volume and hospitalization time of observation group were lower than those of control group(P<0.05);there was no statistically significant difference in fracture healing time between observation group and control group(P>0.05);3 Months,the Harris Harris score of the observation group was higher than that of the control group(P<0.05);6 months after surgery,there was no significant difference in the Harris Harris score of the observation group and the control group(P>0.05);At 3 months,the hip mobility of the observation group was greater than that of the control group(P<0.05);6 months after surgery,there was no statistically significant difference in hip mobility between the observation group and the control group(P>0.05);The surgical complication rate of the patient was 4.00% lower than that of the control group of 17.50%,the difference was statistically significant(P<0.05).Conclusion:Percutaneous prying and PFNA treatment of elderly osteoporotic intertrochanteric fractures have the advantages of less surgical trauma than open reduction PFNA,early postoperative functional exercise to promote hip joint function recovery,and lower surgical complications.