老年性股骨粗隆间骨折应用PFNA内固定手术时机的临床疗效研究

Study on the Clinical Efficacy of PFNA Internal Fixation Surgical Timing in Elderly Patients with Intertrochanteric Fractures

目的探讨老年性股骨粗隆间骨折应用股骨近端防旋髓内钉(PFNA)内固定手术时机的临床疗效。方法选取2020年4月至2021年11月于我院进行手术的股骨粗隆间骨折患者90例,按手术时机分为A组(≤24 h)与B组(>24 h)。术后随访6个月,比较两组的临床疗效、手术情况、住院时间、骨折愈合时间及并发症情况。结果A组治疗优良率高于B组(P<0.05)。两组的手术时间、术后输血量比较无统计学差异(P>0.05)。A组术中出血量、术中输血量高于B组(P<0.05)。A组住院时间及骨折愈合时间短于B组(P<0.05)。A组并发症发生率低于B组(P<0.05)。结论24 h内对老年性股骨粗隆间骨折患者行PFNA内固定手术的疗效更好,有利于骨折愈合及髋关节功能的恢复,减少并发症的发生,但24 h内手术术中出血增多。

Objective To explore the clinical efficacy of proximal femoral nail anti-rotation(PFNA)internal fixation surgical timing in elderly patients with intertrochanteric fractures.Methods 90 patients with intertrochanteric fractures undergoing surgery in our hospital from April 2020 and November 2021 were selected and divided into group A(≤24 h)and group B(>24 h)according to the surgical timing.They were followed up for 6 months after surgery.The clinical efficacy,operation conditions,hospitalization time,fracture healing time and complications were compared between the two groups.Results The excellent and good rate of treatment in group A was higher than that in group B(P<0.05).No statistical difference was found in the operation time and postoperative blood transfusion between the two groups(P>0.05).The intraoperative blood loss and intraoperative blood transfusion of group A were higher than those of group B(P<0.05).The hospitalization time and fracture healing time of group A were shorter than those of group B(P<0.05).The incidence of complications in group A was lower than that in group B(P<0.05).Conclusions PFNA internal fixation surgery within 24 h has better effect in elderly patients with intertrochanteric fractures,which is conducive to fracture healing and the recovery of hip joint function,and reduce the complications,but the intraoperative blood loss increases within 24 h.