股骨近端防旋髓内钉与股骨近端锁定加压钢板手术治疗老年不稳定性股骨粗隆间骨折的临床效果比较

Comparison of Clinical Effects of Proximal Femoral Nail Antirotation and Proximal Femoral Locking Compression Plate Surgery in the Treatment of Unstable Intertrochanteric Fracture of Femur in the Elderly

目的:研究股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)与股骨近端锁定加压钢板(proximal femoral locking compression plate,LCP)手术治疗老年不稳定性股骨粗隆间骨折患者的临床效果。方法:选择2018年1月-2021年1月福州市第二医院100例老年不稳定性股骨粗隆间骨折患者。采用随机数字表法将其分为观察组(n=50)和对照组(n=50)。观察组采用PFNA手术治疗,对照组采用LCP手术治疗。比较两组围手术期指标、并发症、术后3个月时手术效果,术前、术后6个月髋关节功能。结果:观察组手术时间、骨折愈合时间均优于对照组,术中出血量、术中输血量均少于对照组(P<0.05)。观察组术后并发症发生率低于对照组(P<0.05)。术后3个月时,观察组优良率高于对照组(P<0.05)。术后6个月,观察组功能、畸形、活动度、疼痛情况、行走能力评分均高于对照组(P<0.05)。结论:PFNA相较于LCP手术治疗老年不稳定性股骨粗隆间骨折患者效果更好,术后骨折愈合时间更短且髋关节功能恢复效果更好,值得临床推广。

Objective:To study the clinical effect of proximal femoral nail antirotation(PFNA)and proximal femoral locking compression plate(LCP)surgery in the treatment of unstable intertrochanteric fracture of femur in the elderly.Method:From January 2018 to January 2021,100 elderly patients with unstable intertrochanteric fracture of femur were selected from Fuzhou Second Hospital.They were divided into observation group(n=50)and control group(n=50)by random number table method.The observation group was treated with PFNA surgery,and the control group was treated with LCP surgery.The perioperative indexes,complications,surgical effect at 3 months after surgery,hip joint function before and 6 months after surgery were compared between the two groups.Result:The surgery time and fracture healing time of the observation group were better than those of the control group,and the amount of intraoperative bleeding and intraoperative blood transfusion were less than those of the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).At 3 months after surgery,the excellent and good rate of the observation group was higher than that of the control group(P<0.05).Six months after surgery,the scores of function,deformity,mobility,pain condition and walking ability in the observation group were higher than those in the control group(P<0.05).Conclusion:Compared with LCP surgery,PFNA is more effective in the treatment of elderly patients with unstable intertrochanteric fracture of femur,with shorter fracture healing time and better hip function recovery effect,which is worthy of clinical promotion.