小切口置入股骨髓内钉术对股骨转子间骨折患者的影响

Effect of Femoral Intramedullary Nail Placement through Small Incision Operation on Patients with Femoral Intertrochanteric Fracture

目的:探讨小切口置入股骨髓内钉术对股骨转子间骨折患者的影响。方法:选取2019年1月—2022年1月金昌市人民医院98例股骨转子间骨折患者。根据随机数表法将其分为对照组与研究组,各49例。对照组接受常规切口股骨髓内钉内固定术治疗,研究组接受小切口置入股骨髓内钉术治疗。比较两组围手术期指标,术前、术后3个月运动功能及平衡功能,术前与术后1、2、3个月髋关节功能及并发症。结果:研究组的术中失血量、术后引流量均少于对照组,手术时间、住院时间均短于对照组,术后24 h的视觉模拟评分(visual analogue scale,VAS)评分低于对照组(P<0.05)。术后3个月,研究组的改良Barthel指数(modified Barthel index,MBI)、Fugl-Meyer平衡量表(Fugl-Meyer assessment,FMA)评分均高于对照组(P<0.05)。研究组术后1、2、3个月的Harris评分高于对照组(P<0.05)。研究组术后并发症发生率低于对照组(P<0.05)。结论:小切口置入股骨髓内钉术治疗能够有效减轻股骨转子间骨折患者手术创伤与疼痛感,促进患者运动功能与髋关节功能的恢复,缩短患者住院时间并降低并发症发生率。

Objective: To explore the effect of femoral intramedullary nail placement through small incision operation on patients with femoral intertrochanteric fracture. Method: From January 2019 to January 2022, 98 patients with femoral intertrochanteric fracture in Jinchang People’s Hospital were selected. According to the method of random number table, they were divided into the control group and the study group, 49 cases in each group. The control group received conventional incision femoral intramedullary nail internal fixation operation treatment, while the study group received femoral intramedullary nail placement through small incision operation treatment.The perioperative indexes, motor function and balance function before and 3 months after operation, hip joint function before and 1, 2and 3 months after operation and complications were compared between the two groups. Result: The intraoperative blood loss volume and postoperative drainage volume in the study group were less than those in the control group, the operation time and hospital stay were shorter than those in the control group, and the visual analog scale(VAS) score 24 hours after operation was lower than that in the control group(P<0.05). Three months after operation, the scores of modified Barthel index(MBI) and Fugl-Meyer balance scale(FMA) in the study group were higher than those in the control group(P<0.05). Harris score of the study group was higher than that of the control group at 1, 2 and 3 months after operation(P<0.05). The incidence of postoperative complications in the study group was lower than that in the control group(P<0.05). Conclusion: Femoral intramedullary nail placement through small incision operation treatment can effectively reduce the surgical trauma and pain perception of patients with femoral intertrochanteric fracture, promote the recovery of patients’ motor function and hip joint function, shorten the hospital time and reduce the incidence of complications.