急诊闭合复位PFNA内固定手术应用于治疗高龄股骨粗隆间骨折的价值观察

The Value of Emergency Closed Reduction and PFNA Internal Fixation in the Treatment of Intertrochanteric Fractures in the Elderly

目的:分析在股骨粗隆间骨折的高龄老人治疗中应用闭合复位+股骨近端髓内钉(PFNA)治疗,分析其应用价值。方法:选取我院2020年2月-2022年2月收治的44例股骨粗隆间骨折的高龄患者,随机分为2组,每组各22例。对照组治疗方案为动力髋螺钉(DHS)治疗,观察组治疗方案为闭合复位+PFNA治疗。比较2组的手术指标、治疗效果及并发症。结果:观察组的切口长度较对照组更短,同时出血量更少,手术及下床活动时间均更短,差异明显(P<0.05);治疗后,观察组患者Harris评分较对照组更高,且Barthel指数也更高,差异明显(P<0.05);观察组并发症发生率为9.09%,较对照组的36.36%相比,差异明显(P<0.05)。结论:对高龄患者应用闭合复位+PFNA治疗可获得更好的治疗效果,可降低手术创伤,促进其功能恢复,减少并发症发生,具有较高的治疗价值。

Objective:To analyze the application of closed reduction plus proximal femoral intramedullary nail(PFNA)in the treat-ment of intertrochanteric fractures in the elderly and analyze its application value.Methods:Forty-four elderly patients with intertro-chanteric fracture of femur were selected from February 2020 to February 2022 and randomly divided into two groups,with 22 cases in each group.Control group:dynamic hip screw(DHS)treatment;Treatment plan of observation group:closed reduction+PFNA treat-ment.The operation index,treatment effect and complications were compared between the two groups.Results:Compared with the con-trol group,the length of incision in the observation group was shorter,the amount of blood loss was less,the operation time and ambula-tion time were shorter,and the differences were significant(P<0.05).After treatment,the Harris score and Barthel index of the ob-servation group were higher than those of the control group,and the differences were significant(P<0.05).The complication rate of the observation group was 9.09%,which was significantly higher than that of the control group(36.36%)(P<0.05).Conclusion:The application of closed reduction+PFNA in the treatment of elderly patients can obtain better treatment effect,reduce the surgical trauma,promote the recovery of function,reduce the incidence of complications,and has high therapeutic value.