股骨近端髓内钉内固定术和人工全髋关节置换治疗老年股骨转子间骨折患者的效果对比

Comparison of the Effects of Proximal Femoral Nail Antirotation and A rtificial Total Hip Replacement in the Treatment of Elderly Patients with Femoral Intertrochanteric Fractures

目的比较股骨近端髓内钉内固定术(PFNA)与人工全髋关节置换术对老年股骨转子间骨折患者的治疗效果。方法回顾性选取2019年1月至2021年6月范县中医院收治的85例老年股骨转子间骨折患者,按手术方法分为两组。PFNA组40例,全髋关节置换组45例。比较两组手术参数指标及术后恢复指标。结果全髋关节置换组术中出血量多于PFNA组,透视次数少于PFNA组,平均住院时长、患肢负重时间、下地时间、切口长度均短于PFNA组(P<0.05)。全髋关节置换组术后3个月关节恢复优良率(97.78%)高于PFNA组(80.00%),Harris评分[(89.65±5.16)分]高于PFNA组[(71.53±5.28)分],术后并发症发生率(6.67%)低于PFNA组(27.50%)(P<0.05)。全髋关节置换组术后3个月生理职能、生理功能、总体健康、活力评分高于PFNA组(P<0.05)。结论PFNA与人工全髋关节置换术治疗老年股骨转子间骨折患者均有较好效果,与PFNA相比,人工全髋关节置换术后患者髋关节功能恢复好,并发症少,值得临床进一步探讨。

Objective To compare the effect of proximal femoral nail antirotation(PFNA)and artificial total hip replacement in the treatment of elderly patients with femoral intertrochanteric fractures.Methods A total of 85 elderly patients with femoral intertrochanteric fractures in Fan County Hospital of Traditional Chinese Medicine from January 2019 to June 2021 were retrospectively selected and divided into two groups according to surgical methods.There were 40 cases in the PFNA group and 45 cases in the total hip replacement group.The surgery parameters and postoperative recovery indicators were compared between the two groups.Results The intraoperative blood loss of the total hip replacement group was more than that of the PFNA group,the number of fluoroscopy was less than that of the PFNA group,and the average length of hospitalization,the weight-bearing time of the affected limb,the time spent on the ground and the incision length were lower than those of the PFNA group(P<0.05).The excellent and good rate of joint recovery at 3 months in the total hip replacement group(97.78%)was higher than that of the PFNA group(80.00%),the Harris score[(89.65±5.16)points]was higher than the PFNA group[(71.53±5.28)points],and the postoperative complications(6.67%)were lower than that of the PFNA group(27.50%)(P<0.05).The physiological function,physiological function,overall health and vitality scores of the total hip replacement group were higher than that of the PFNA group at 3 months after the operation(P<0.05).Conclusion Both PFNA and artificial total hip replacement are effective in the treatment of elderly patients with femoral intertrochanteric fractures.Compared with PFNA,patients after artifcial total hip replacement have better hip function recovery and fewer complications,which is worthy of further climical investigation.