倒置髓内钉与微创固定系统钢板治疗老年股骨远端骨折的效果

Effects of inverted intramedullary nail and minimally invasive fixation system plate on distal femoral fracture in the elderly

目的探讨倒置髓内钉与微创固定系统(LISS)钢板治疗老年股骨远端骨折的效果。方法选取2017年6月至2021年3月许昌市中心医院收治的老年股骨远端骨折患者84例。根据随机数字表法分为髓内钉组和钢板组,每组42例。髓内钉组采用倒置髓内钉治疗,钢板组予以LISS钢板治疗。对比两组围术期情况、膝关节功能优良率、日常生活活动能力(ADL)、下肢运动功能(FMA)及并发症发生情况。结果与钢板组相比,髓内钉组手术时间较长,切口长度较短,术中出血量较少(P<0.05)。两组住院时间比较差异未见统计学意义(P>0.05)。髓内钉组膝关节功能优良率(83.33%,35/42)较钢板组(59.52%,25/42)高,差异有统计学意义(χ^(2)=5.833,P<0.05)。术前,两组ADL、FMA评分比较差异未见统计学意义(P>0.05);术后10个月,髓内钉组ADL、FMA评分较钢板组高(P<0.05)。髓内钉组并发症发生率(4.76%,2/42)较钢板组(21.43%,9/42)低,差异有统计学意义(χ^(2)=5.126,P<0.05)。结论与LISS钢板相比,老年股骨远端骨折患者采用倒置髓内钉治疗,可改善膝关节和下肢运动功能,提高日常生活能力,且并发症发生率低。

Objective To investigate the effect of inverted intramedullary nail and minimally invasive fixation system(LISS)plate on distal femoral fractures in the elderly.Methods Eightyfour elderly patients with distal femoral fractures treated in Xuchang Central Hospital from June 2017to March 2021 were selected.According to the random number table,they were divided into intramedullary nail group and steel plate group,with 42 cases in each group.The intramedullary nail group was treated with inverted intramedullary nail,and the steel plate group was treated with LISS steel plate.The perioperative conditions,excellent and good rate of knee function,activity of daily living(ADL),lower extremity motor function(FMA)and complications were compared between the two groups.Results Compared with the steel plate group,the intramedullary nail group had longer operation time,shorter wound length and less intraoperative bleeding(P<0.05).There was no significant difference in hospital stay between the two groups(P>0.05).The excellent and good rate of knee joint function in intramedullary nail group(83.33%,35/42)was higher than that in steel plate group(59.52%,25/42),and the difference was significant(χ^(2)=5.833,P<0.05).Before operation,there was no significant difference in ADL and FMA scores between the two groups(P>0.05).Ten months after operation,the ADL and FMA scores of intramedullary nail group were higher than those of steel plate group(P<0.05).The incidence of complications in the intramedullary nail group(4.76%,2/42)was lower than that in the steel plate group(21.43%,9/42),and the difference was significant(χ^(2)=5.126,P<0.05).Conclusions Compared with LISS plate,the elderly patients with distal femoral fracture treated with inverted intramedullary nail can improve the knee joint and lower limb motor function,improve the ability of daily living,and the incidence of complications is low.