股骨近端防旋髓内钉与动力髋螺钉内固定治疗股骨粗隆间骨折的效果比较

A Comparative Study on the Effect of Internal Fixation of Proximal Femoral Anti Rotation Intramedullary Nail and Dynamic Hip Screw in the Treatment of Intertrochanteric Fracture

目的分析对比股骨粗隆间骨折采用股骨近端防旋髓内钉与动力髋螺钉内固定的治疗效果。方法研究活动实施时间段为2018年4月至2019年4月,选择该时间段我院接诊的股骨粗隆间骨折患者82例。通过随机单复数分组方法将患者分为两组,对照组和观察组患者例数都为41例。对照组患者采用动力髋螺钉内固定术治疗,观察组患者应用股骨近端方旋髓内钉内固定术治疗。对比分析两组患者的临床效果。结果①观察组(3例,占7.32%)的并发症发生概率相比对照组(13例,占31.71%)更低,差异有统计学意义(P<0.05)。②观察组患者的手术时间、术中出血量、伤口愈合时间、住院时间少于对照组,差异有统计学意义(P<0.05)。③两组患者术前,VAS评分和Harris评分无明显区别,差异无统计学意义(P>0.05),术后观察组患者的VAS评分和Harris评分改善效果相比对照组更为满意,差异有统计学意义(P<0.05)。④术前,两组患者在生活质量方面没有显著性差异(P>0.05),术后观察组的生活质量得到更为可靠的改善,差异有统计学意义(P<0.05)。⑤观察组(39例,占95.12%)对满意度的评价水平相比对照组(32例,占78.05%)更高,差异有统计学意义(P<0.05)。结论在股骨粗隆间骨折患者的治疗中,通过股骨近端防旋髓内钉内固定手术治疗所取得的效果比动力髋螺钉内固定的效果更为理想,不仅可以促进患者的骨折恢复,还能有效的提升治疗的安全性,保证了患者的生活质量,使患者对治疗工作更为满意,值得推荐。

Objective To analyze and compare the therapeutic effect of proximal femoral anti rotation intramedullary nail and dynamic hip screw in the treatment of intertrochanteric fracture.Methods From April 2018 to April 2019,82 patients with intertrochanteric fracture were selected.The patients were divided into two groups by the method of random singular and plural grouping.There were 41 patients in the control group and 41 patients in the observation group.The patients in the control group were treated with dynamic hip screw internal fixation,and the patients in the observation group were treated with proximal femoral screw internal fixation.The clinical effects of the two groups were compared.Results(1)The incidence of complications after treatment in the observation group(3 cases,accounting for 7.32%)was significantly lower than that in the control group(13 cases,accounting for 31.71%),and the difference was statistically significant(P<0.05).(2)The operation time,intraoperative blood loss,wound healing time and hospital stay of the observation group were significantly shorter than those of the control group,and the difference was statistically significant(P<0.05).(3)There was no significant difference in the VAS and Harris score between the two groups before operation,and the difference was not statistically significant(P>0.05).All patients in VAS and Harris score were improved after surgery,but the improvement effect of the observation group was significantly better than that of the control group,and the difference was statistically significant(P<0.05).(4)There was no significant difference in the quality of life scores between the two groups before operation,and the difference was not statistically significant(P>0.05).Both groups in the quality of life scores were improved after operation,but the improvement effect of the observation group was significantly better than that of the control group,and the difference was statistically significant(P<0.05).(5)The satisfaction of patients in the observation group(39 cases,accounting for 95.12%)was significantly higher than that in the control group(32 cases,accounting for 78.05%),and the difference was statistically significant(P<0.05).Conclusion In the treatment of patients with femoral intertrochanteric fractures,the effect of proximal femoral anti-rotation intramedullary nail fixation is more ideal than that of dynamic hip screw fixation.It can effectively improve the safety of treatment,ensure the quality of life of patients,and make patients more satisfied with the treatment work,which is worthy of recommendation.