PFNA治疗老年性股骨粗隆间骨折的效果及临床预后分析

Effect of PFNA in the Treatment of Senile Intertrochanteric Fracture and Its Clinical Prognosis

目的:探究防旋股骨髓内钉(PFNA)在老年股骨粗隆间骨折治疗中的应用及对患者髋关节功能的影响。方法:随机在2015年4月-2019年4月收治的老年性股骨粗隆间骨折患者中选取86例作为研究对象,以抽签法将其随机分成两组,其中对照组(n=43)以动力髋螺钉(DHS)复位固定,观察组(n=43)以PENA复位固定。对比两组患者的愈合情况,髋关节功能Harris评分,术后并发症的发生情况。结果:观察组患者术后手术时间、骨折愈合时间短于对照组,出血少于对照组,两组对比差异有统计学意义(P<0.05)。观察组术后3、6、12个月髋关节Harris评分均高于对照组,差异有统计学意义(P<0.05)。观察组术后髋内翻、螺钉切割或穿出股骨头、感染等发生率低于对照组,差异有统计学意义(P<0.05)。结论:PFNA治疗老年性股骨粗隆间骨折,能促进患者关节功能的恢复,缩短患者的骨折愈合时间,降低手术相关并发症的发生,具有较大的临床应用价值,值得推广。

Objective:To explore the application of proximal femoral nail antirotation (PFNA) in the treatment of intertrochanteric fracture in the elderly and its influence on hip joint function.Method:A total of 86 cases of senile intertrochanteric fracture from April 2015 to April 2019 were randomly divided into two groups by drawing lots.The control group (n=43) was treated with dynamic hip screw (DHS),and the observation group (n=43) was treated with PENA repositioning fixation.The healing condition,Harris hip function score and postoperative complications were compared between the two groups.Result:The operation time and fracture healing time of the observation group were shorter than those of the control group,and the bleeding was less than that of the control group (P<0.05).The Harris score of hip joint in the observation group was higher than that in the control group at 3,6 months and 12 months after operation,with statistical significance (P<0.05).The incidence of hip varus,screw cutting or penetrating the femoral head and infection in the observation group were lower than those in the control group (P<0.05).Conclusion:PFNA in the treatment of senile intertrochanteric fracture can promote the recovery of joint function,shorten the fracture healing time and reduce the occurrence of operation related complications.It has great clinical application value and is worthy of promotion.