骨科康复一体化在PFN-A内固定治疗股骨粗隆间骨折中的应用效果

Effect of orthopedic rehabilitation integration in PFN-A internal fixation in the treatment of femoral intertrochanteric fracture

目的探讨骨科康复一体化在股骨近端防旋髓内钉(PFN-A)内固定治疗股骨粗隆间骨折中的应用效果。方法选择福建中医药大学附属康复医院运动医学科(骨科)2019年12月至2021年6月接诊的60例股骨粗隆间骨折患者为研究对象,通过随机数表法分为观察组和对照组,每组各30例,对照组采用常规模式干预,观察组采用骨科康复一体化干预。比较两组患者术前及术后1、2、12、24周视觉模拟评分(VAS),术前及术后12周髋关节评分量表(Harris)、膝关节评分量表(HSS)评分的变化,并比较两组关节优良率、住院情况、术后并发症发生率及患者满意度。结果术后1、2、12、24周时,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);术后12周时,观察组Harris评分和HSS评分高于对照组,差异有统计学意义(P<0.05);术后24周时,和对照组相比,观察组关节功能优良率更高,差异有统计学意义(P<0.05);和对照组相比,观察组住院时间更长、住院费用更高,差异有统计学意义(P<0.05);术后24周复查显示,观察组术后并发症总发生率低于对照组,总满意度高于对照组,差异有统计学意义(P<0.05)。结论股骨粗隆间骨折患者在PFN-A内固定术后采用骨科康复一体化干预,可以降低VAS评分,有助于髋关节、膝关节功能的恢复,提高关节功能优良率,减少术后并发症,值得在股骨粗隆间骨折患者中推广应用。

Objective To investigate the efficacy of orthopedic rehabilitation integration in proximal femoral nail anti-rotation(PFN-A)internal fixation in the treatment of femoral intertrochanteric fracture.Methods A total of 60 patients with femoral intertrochanteric fracture admitted to the Department of Sports Medicine(Orthopedics)in the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from December 2019 to June 2021 were selected as the research snbjects.They were divided into the observation group(n=30)and the control group(n=30)according to the random number table method.The control group was treated with conventional intervention,while the observation group was treated with integrative intervention of orthopedic rehabilitation.The visual analogue scale(VAS)score before and 1,2,12 and 24 weeks after surgery,changes in hip joint rating scale(Harris)and knee joint rating scale(HSS)scores before and 12 weeks after surgery were compared between the patients of the two groups.The excellent rate of joints,hospitalization condition,incidence of postoperative complications and patient satisfaction were also compared between the two groups.Results At 1,2,12 and 24 weeks after surgery,VAS scores in the observation group were all lower than those in the control group,with statistically significant difference(P<0.05).At 12 weeks after surgery,the Harris score and HSS score in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).At 24 weeks after surgery,compared with the control group,the excellent rate of joint function in the observation group was higher,with statistically significant difference(P<0.05).Compared with the control group,the observation group had a longer hospitalization time and higher hospitalization expense,with statistically significant differences(P<0.05).At 24 weeks after surgery,the reexamination results showed that the overall incidence of postoperative complications in the observation group was lower than that in the control group,and the total satisfaction was higher than that in the control group,with statistically significant differences(P<0.05).Conclusion After PFN-A internal fixation,patients with femoral intertrochanteric fracture can reduce VAS score by using orthopedic rehabilitation integrated intervention.It is helpful to restore the function of hip and knee joints,improve the excellent rate of joints function,and reduce incidence of postoperative complications.Therefore,it is worthy of promotion and application in patients with femoral intertrochanteric fracture.