闭合复位防旋髓内钉内固定术对股骨粗隆骨折患者髋关节功能及生活质量的影响

Effect of Closed Reduction and Proximal Femoral Nail Anti-rotation Fixation on Hip Joint Function and Quality of Life in Patients with Femoral Intertrochanteric Fracture

目的 研究闭合复位防旋髓内钉(PFNA)内固定术对股骨粗隆骨折患者髋关节功能及生活质量的影响。方法 收集2019年5月-2021年5月上高县人民医院收治的68例股骨粗隆间骨折患者,经随机数字表法分为对照组(34例)与观察组(34例),对照组行切开复位PFNA内固定术治疗,观察组行闭合复位PFNA内固定术治疗,比较两组围术期指标、髋关节功能(Harris髋关节功能评分)、手术并发症、生活能力[Barthel指数(BI)评分]、生活质量[健康调查简表(SF-36)评分]。结果 观察组术中出血量少于对照组,住院时间、负重开始时间、骨折愈合时间短于对照组(P<0.05);观察组术后3个月Harris各维度评分均高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05);观察组术后6个月BI指数、SF-36评分高于对照组(P<0.05)。结论 闭合复位PFNA内固定术可有效改善股骨粗隆骨折患者的髋关节功能,其手术出血少、并发症风险低,可缩短患者康复时间,有利于术后生活质量的改善。

Objective To study the effect of closed reduction and proximal femoral nail anti-rotation(PFNA) internal fixation on hip joint function and quality of life in patients with femoral intertrochanteric fracture.Methods A total of 68 patients with femoral intertrochanteric fractures admitted to Shanggao County People’s Hospital from May 2019 to May 2021 were collected and divided into a control group(34 cases) and an observation group(34 cases) by random number table method. The control group was treated with open reduction and PFNA internal fixation, while the observation group was treated with closed reduction and PFNA internal fixation. Perioperative indexes, hip function(Harris hip function score), surgical complications, living ability [Barthel index(BI) score ] and quality of life [health survey summary(SF-36) score] were compared between the two groups.Results The amount of bleeding in the observation group was less than that in the control group, and the hospitalization time, weight-bearing start time and fracture healing time were shorter than those in the control group(P<0.05). The Harris scores of each dimension in the observation group were higher than those in the control group at 3 months after operation(P<0.05). The incidence of complications in the observation group was lower than that in the control group(P<0.05). The BI index and SF-36 score of the observation group were higher than those of the control group at 6months after operation(P<0.05).Conclusion Closed reduction and PFNA internal fixation can effectively improve the hip joint function of patients with femoral trochanteric fracture, with less bleeding and low risk of complications. It can shorten the recovery time of patients and improve the quality of life after operation.