PFNA与钢板内固定治疗股骨粗隆间骨折的临床疗效比较

Comparison of Clinical Efficacy Between PFNA and Internal Fixation with Plate in the Treatment of Femoral Intertrochanteric Fractures

目的 对比研究股骨近端抗旋髓内钉(PFNA)与钢板内固定方法对股骨粗隆间骨折患者的临床疗效。方法 方便选取该院2014年10月—2020年8月期间收治的92例股骨粗隆间骨折患者,根据手术方式不同分为对照组(n=30例,接受钢板内固定治疗)和研究组(n=62例,接受PFNA治疗),比较两组患者临床治疗效果。结果 研究组治疗1、6、12个月后髋关节功能评分结果均高于对照组,差异有统计学意义(P<0.05);研究组切口总长度(8.44±1.08)cm、手术时间(59.14±7.65)min、下床不负重活动时间(7.58±1.22)d、骨折愈合时间(12.89±1.09)周、术中出血量(156.21±10.88)mL均优于对照组,差异有统计学意义(t=14.465、18.765、26.123、8.250、46.954,P<0.05);治疗后,研究组各项生活质量评分(精神状态、生理功能、总体健康、社会功能)均高于对照组,差异有统计学意义(P<0.05);研究组并发症发生率(3.22%)低于对照组,差异有统计学意义(χ^(2)=9.174,P<0.05)。结论 与钢板内固定治疗效果相比,股骨粗隆间骨折患者应用PFNA治疗的效果突出。

Objective To compare the clinical efficacy of proximal femoral anti-rotation intramedullary nail(PFNA)and plate internal fixation in patients with femoral intertrochanteric fractures.Methods A total of 92 patients with femoral intertrochanteric fractures who were admitted to the hospital from October 2014 to August 2020 were conveniently selected.According to different surgical methods,they were divided into control group(n=30 cases,receiving plate internal fixation)and study group(n=62 cases,receiving PFNA treatment),and the clinical treatment effects of the two groups were compared.Results After 1,6 and 12 months of treatment,the hip joint function scores in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The total length of the incision(8.44±1.08)cm,the operation time(59.14±7.65)min,the time of getting out of bed without weight-bearing activity(7.58±1.22)d,the fracture healing time(12.89±1.09)weeks,and the intraoperative blood loss(156.21±10.88)mL in the study group were better than those in the control group,and the difference was statistically significant(t=14.465,18.765,26.123,8.250,46.954,P<0.05).After treatment,the quality of life scores(mental state,physical function,overall health,and social function)in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05);the incidence of complications in the study group(3.22%)lower than the control group,the difference was statistically significant(χ^(2)=9.174,P<0.05).Conclusion Compared with the treatment effect of plate internal fixation,the effect of PFNA in the treatment of femoral intertrochanteric fractures is outstanding.