股骨近端防旋髓内钉和解剖锁定钢板治疗老年股骨转子间骨折的临床效果比较

Comparison of Clinical Effects of Proximal Femoral Nail and Anatomical Locking Plate in the Treatment of Intertrochanteric Fractures in the Elderly

目的对老年股骨转子间骨折患者,采用股骨近端防旋内钉法和解剖锁定钢板法进行治疗,比较临床治疗效果。方法选取自2019年3月至2020年6月在我院接受治疗的老年股骨转子间骨折患者168例,按照治疗方法的不同,分为内钉组和钢板组各84例。内钉组采用股骨近端防旋髓内钉法,钢板组采用解剖锁定钢板法,统计两组患者的平均切口长度、平均手术时间、平均出血量、平均骨折愈合时间及术后Harris评分,对比两组患者的临床治疗效果。结果平均切口长度指标,内钉组为(6.26±1.23)cm,钢板组为(11.32±2.51)cm,P<0.05;平均手术时间指标,内钉组为(61.22±4.09)min,钢板组为(80.13±4.61)min,P<0.05;平均出血量指标,内钉组为(65.13±21.07)mL,钢板组为(108.07±29.72)mL,P<0.05;平均骨折愈合时间指标,内钉组(10.11±2.25)周,钢板组为(10.21±2.73)周,P>0.05。术后Harris评分:优秀指标,内钉组为38例,占比为45.24%,钢板组为28例,占比为33.33%,P<0.05;良好指标,内钉组为33例,占比为39.28%,钢板组为26例,占比为30.95%,P<0.05;尚可指标:内钉组为12例,占比为14.29%,钢板组为17例,占比为20.24%,P<0.05;差指标:内钉组为1例,占比为1.19%,钢板组为13例,占比为15.48%,P<0.05。结论在对老年股骨转子间骨折的患者进行治疗时,采用股骨近端防旋髓内钉方法与采用解剖锁定钢板法进行治疗在平均切口长度、平均手术时间、平均出血量、术后Harris评分方面具有明显的优势。采用股骨近端防旋髓内钉方法进行治疗,能患者在手术后更多的体会到生活中的乐趣,防止心态失衡,值得推广该手术。

Objective To compare the clinical effect of Proximal femoral nail and anatomical locking plate in the treatment of elderly patients with intertrochanteric fracture. Methods One hundred and sixty-eight elderly patients with intertrochanteric fracture in our hospital from March 2019 to June 2020 were selected. According to different treatment methods, they were divided into internal nail group and plate group, 84 cases in each group. The proximal femoral nail antirotation method was used in the internal nail group, and the anatomical locking plate method was used in the plate group. The average length of incision, the average operation time, the average amount of bleeding, the average time of fracture healing and the Harris score were compared between the two groups, the clinical curative effect of the two groups was compared. Results The average incision length index was(6.26±1.23) cm in the internal nail group and(11.32±2.51) cm in the steel plate group, P< 0.05. The average operation time index was(61.22±4.09) min in the internal nail group and(80.13±4.61) min in the steel plate group, P< 0.05. The average blood loss index was(65.13±21.07)mL in the internal nail group and(108.07±29.72) mL in the steel plate group, P<0.05. The average fracture healing time index was(10.11±2.25) weeks in the internal nail group and(10.21±2.73) weeks in the steel plate group, P>0.05. Harris score after surgery: For excellent indicators, there were 38 cases in the internal nail group, accounting for 45.24%, and 28 cases in the steel plate group, accounting for 33.33%, P<0.05. Good indicators, 33 cases in the internal nail group, accounting for 39.28%, and 26 cases in the steel plate group, accounting for 30.95%, P<0.05. Acceptable indicators: 12 cases in the internal nail group, accounting for 14.29%, and 17 cases in the steel plate group, accounting for 20.24%, P<0.05. Poor indicators: 1 case in the internal nail group, accounting for 1.19%, and 13 cases in the steel plate group, accounting for 15.48%, P<0.05. Conclusion In the treatment of elderly patients with femoral intertrochanteric fractures, the use of proximal femoral anti-rotation intramedullary nails and the anatomical locking plate method for treatment are in terms of average incision length, average operation time, average blood loss, and postoperative Harris score has obvious advantages. The treatment with the anti-rotation intramedullary nail at the proximal end of the femur can enable patients to experience more joy in life after the operation and prevent mental imbalance. It is worth promoting the operation.