手法复位PFNA内固定治疗股骨粗隆间骨折对髋关节功能、复位情况及并发症的影响

Effect of manual reduction of PFNA for intertrochanteric fracture on hip function,reduction and complications

目的 探究手法复位PFNA内固定治疗股骨粗隆间骨折对髋关节功能、复位情况及并发症的影响。方法 回顾性分析济源市卫生学校附属医院2018年3月—2020年3月收治的201例PFNA内固定治疗股骨粗隆间骨折患者的临床资料,按其牵引方法分为无需牵引床手法复位(无需牵引组,120例)与牵引床复位(牵引床组,81例),分析两组患者手术相关指标,观察其复位情况、术后并发症及术后随访1个月、3个月及6个月髋关节功能Harris评分。结果 (1) 201例PFNA内固定治疗股骨粗隆间骨折患者在术后回访均获得骨性愈合,无需牵引床组患者术前准备时间、手术时间均低于牵引床组患者(t=20.481、5.786,P<0.05)。(2)无需牵引床组患者术后有6例患者存在并发症;牵引床组出现42例术后并发症患者;牵引床组术后出现并发症的情况高于无需牵引床组,除髋关节内翻外其余组间差异具有统计学意义(P<0.05)。结论 PFNA内固定治疗股骨粗隆间骨折效果良好,采用非牵引床手法复位的患者缩短了术前准备及手术时间、骨折愈合时间较短,术后并发症出现情况较少,髋关节功能Harris评分较好,值得临床借鉴参考。

Objective To explore the effect of PFNA reduction for intertrochanteric fracture on hip function,reduction and complications.MethodsThe clinical data of 201 patients with PFNA internal fixation for intertrochanteric fracture were analyzed from March 2018 to March 2020,according to the traction method they were divided into non-bed manual group(120 patients)and traction bed group,81 patients),the surgical indexes were analyzed,observed the reduction,postoperative complications and Harris score of hip joint function at 1 month,3 months and 6 months postoperative follow-up.Results 201 patients with PFNA intertrochanteric fracture,all were followed up bony recovering and the preoperative preparation time of patients in the non-traction bed group were lower than those of patients in the traction bed group(t=20.481,5.786,P<0.05).Six patients had postoperative complications in the non-bed maunul group;42 patients had postoperative complications the traction bed group;postoperative complications the traction bed group were higher than those in the non-traction bed group,with significant differences except hip varus(P<0.05).Conclusion PFNA internal fixation in the treatment of intertrochanteric fracture is good,and patients with non-traction bed manual reduction shorten the preoperative preparation,operation time,fracture healing time,fewer postoperative complications,and good hip function Harris score,which is worthy of clinical reference.