股骨近端防旋髓内钉治疗老年股骨转子间骨折的临床效果

Clinical Effect of Proximal Femoral Nail Antirotation in the Treatment of Elderly Intertrochanteric Fracture of Femur

目的:研究股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的临床效果。方法:选择2021年6月—2022年6月茂名市人民医院收治的80例老年股骨转子间骨折患者为研究对象,将其按照治疗方法不同分为两组,各40例。Ⅰ组采用动力髋螺钉治疗,Ⅱ组采用PFNA治疗。比较两组围手术期指标、并发症情况及治疗前后髋关节功能评分、生活质量评分。结果:Ⅱ组切口长度、手术时间、骨痂形成时间、骨折愈合时间均短于Ⅰ组,术中出血量少于Ⅰ组,差异有统计学意义(P<0.05)。治疗后,两组髋关节功能评分均高于治疗前,且Ⅱ组高于Ⅰ组,差异有统计学意义(P<0.05)。Ⅱ组内固定物松动、断钉、患肢短缩、髋外翻、术后感染等并发症总发生率低于Ⅰ组,差异有统计学意义(P<0.05)。治疗后,两组生活质量评分均高于治疗前,且Ⅱ组高于Ⅰ组,差异有统计学意义(P<0.05)。结论:对于老年股骨转子间骨折患者而言,PFNA治疗可促进术后恢复,改善髋关节功能,还可以减少并发症发生,提高患者生活质量。

Objective:To study the clinical effect of proximal femoral nail antirotation(PFNA)in the treatment of elderly intertrochanteric fracture of femur.Method:A total of 80 elderly patients with intertrochanteric fracture of femur treated in Maoming People's Hospital from June 2021 to June 2022 were selected as the study objects,and they were divided into two groups according to different treatment methods,with 40 cases in each group.GroupⅠwas treated with dynamic hip screw,groupⅡwas treated with PFNA.Perioperative indexes,complications,hip joint function scores and quality of life scores before and after treatment were compared between the two groups.Result:The incision length,surgical time,callus formation time,and fracture healing time in groupⅡwere all shorter than those in groupⅠ,the intraoperative bleeding was less than that in groupⅠ,and the differences were statistically significant(P<0.05).After treatment,the hip joint function scores of both groups were higher than those before treatment,and the scores of groupⅡwas higher than that of groupⅠ,the differences were statistically significant(P<0.05).The total incidence of complications such as loosening of fixators,broken nails,shortening of affected limbs,coxa valgus,and postoperative infection in groupⅡwas lower than that in groupⅠ,and the difference was statistically significant(P<0.05).After treatment,the quality of life scores of both groups were higher than those before treatment,and the scores of groupⅡwas higher than that of groupⅠ,the differences were statistically significant(P<0.05).Conclusion:For elderly patients with intertrochanteric fracture of femur,PFNA treatment can promote postoperative recovery,improve hip joint function,reduce complications,and improve patient quality of life.