股骨近端髓内钉治疗股骨粗隆骨折的疗效

The Effect of Proximal Femoral Intramedullary Nail in the Treatment of Femoral Trochanteric Fractures

目的探讨股骨近端髓内钉治疗股骨粗隆骨折的的临床效果。方法选择该院2018年1月—2019年12月收治的股骨粗隆骨折患者70例为对象,随机数字表法将患者分成对照组(n=35)和观察组(n=35)。对照组用动力髋螺钉治疗,观察组用股骨近端髓内钉治疗,比较两组的围术期指标和并发症发生率。结果观察组手术切口(4.3±0.6)cm小于对照组(7.8±0.2)cm,观察组术中出血量(200.8±28.3)mL少于对照组(312.5±30.4)mL,观察组手术时间(68.0±8.3)min短于对照组(96.3±6.8)min,观察组术后视觉模拟评分法(VAS)评分(3.0±0.7)分低于对照组(5.6±0.4)分,观察组负重活动时间(23.8±5.4)d短于对照组(34.5±3.5)d,观察组骨折愈合时间(3.0±0.5)个月短于对照组(5.1±1.7)个月,观察组随访Harris评分(92.6±2.3)分高于对照组(80.8±2.4)分,差异有统计学意义(t=32.740、15.911、15.604、19.079、9.837、7.011、21.001,P<0.001)。观察组并发症发生率2.9%低于对照组22.9%,差异有统计学意义(χ^(2)=4.590,P=0.032)。结论股骨粗隆骨折采用股骨近端髓内钉治疗的手术切口小,术中出血量少,术后疼痛程度低,髋关节功能恢复显著,并发症少。

Objective To investigate the clinical effect of proximal femoral intramedullary nail in the treatment of femoral trochanteric fractures.Methods Seventy patients with femoral tuberosity fractures admitted to the hospital from January 2018 to December 2019 were selected as subjects.The patients were divided into a control group(n=35)and an observation group(n=35)by a random number table method.The control group was treated with dynamic hip screws,and the observation group was treated with proximal femoral nails.The perioperative indicators and complication rates of the two groups were compared.Results The surgical incision(4.3±0.6)cm of the observation group was smaller than the control group(7.8±0.2)cm,the intraoperative blood loss(200.8±28.3)mL of the observation group was less than the control group(312.5±30.4)mL,and the operation time of the observation group was(68.0±8.3)min iwas shorter than the control group(96.3±6.8)min,the postoperative VAS score of the observation group(3.0±0.7)points was lower than the control group(5.6±0.4)points,and the weight-bearing activity time of the observation group was(23.8±5.4)d shorter than the control group(34.5±3.5)d,the fracture healing time of the observation group was(3.0±0.5)months shorter than that of the control group(5.1±1.7)months,and the follow-up Harris score(92.6±2.3)points of the observation group was higher than that of the control group(80.8±2.4)points,the difference was statistically significant(t=32.740,15.911,15.604,19.079,9.837,7.011,21.001,P<0.001).The complication rate of the observation group was 2.9%lower than that of the control group 22.9%,and the difference was statistically significant(χ^(2)=4.590,P=0.032).Conclusion The use of proximal femoral intramedullary nails for the treatment of femoral trochanteric fractures requires small surgical incisions,low intraoperative blood loss,low postoperative pain,significant recovery of hip joint function,and fewer complications.