小切口股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的临床疗效

Clinical Effects of Small Incision Proximal Femoral Nail Anti Rotation in the Treatment of Intertrochanteric Fracture of Femur in the Elderly

目的:探析老年股骨粗隆间骨折通过小切口股骨近端防旋髓内钉(PFNA)进行治疗的效果。方法:将某院2017年1月~2019年1月收治的88例老年股骨粗隆间骨折患者按照手术方法的区别分为对照组和实验组各44例,对照组采用动力髋螺钉(DHS),实验组采用小切口股骨近端防旋髓内钉(PFNA),对比两组手术优良率、术后恢复情况、手术前后半年髋关节功能评分变化以及术后并发症发生率。结果:实验组下床活动时间、术后住院时间、骨折愈合时间均短于对照组(P<0.05);实验组手术优良率为86.36%,高于对照组的61.36%(P<0.05);术后半年,实验组髋关节功能评分高于术前(P<0.05),且高于对照组(P<0.05);实验组畸形愈合、内固定松动或者断裂、髋关节内翻总发生率为4.55%,低于对照组的18.18%(P<0.05)。结论:小切口股骨近端防旋髓内钉用于老年股骨粗隆间骨折患者中能获得较为理想的效果,提升手术优良率,降低并发症发生率,促进术后康复,改善患者的髋关节功能,有着极大的临床推广价值。

Objective:To explore the effect of small incision PFNA in the treatment of intertrochanteric fractures in the elderly.Methods:88 elderly patients with intertrochanteric fractures in a hospital from January 2017 to January 2019 were divided into control group[(n=44,dynamic hip screw(DHS)]and experimental group[n=44,small incision proximal femoral nail anti rotation(PFNA)]according to the surgical methods.The excellent rate of operation,postoperative recovery,changes in hip function scores,and the incidence of postoperative complications were compared.between the two groups.Results:The activity time out of bed,postoperative bed hospitalization time and fracture healing time in the experimental group were shorter than those in the control group(P<0.05).The excellent rate in the experimental group was 86.36%,higher than 61.36% in the control group(P<0.05).Six months after surgery,the hip function score in the experimental group was higher than that before surgery(P<0.05),and higher than that in the control group(P<0.05).The total incidence of deformity healing,internal fixation or fracture,and hip overturning was 4.55%,lower than 18.18%in the control group(P<0.05).Conclusion:The application of small incision proximal femoral nail anti rotation in the elderly patients with intertrochanteric fracture of femur can obtain ideal effect,improve the excellent rate of operation and reduce the incidence of complications,which has great clinical promotion value.