体外冲击波治疗法对老年股骨粗隆间骨折PFNA术后影响

Effect of shock wave therapy on the elderly after PFNA for intertrochanteric fractures of the femur

目的探讨体外冲击波疗法(ESWT)对老年股骨粗隆间骨折PFNA术后的影响。方法将老年股骨粗隆间骨折PFNA术后的120例患者作为研究对象,随机分为术后冲击波治疗组(A组)和对照组(B组),每组60例,比较2组患者术后不同时间段骨折愈合率,比较2组患者术后VAS、HAMA、HAMD、Harris评分。结果患者术后均随访1年,A组在术后1~3个月、3~6个月、6~9个月、9~12个月骨折愈合率高于B组(P<0.05)。术后1个月、2个月VAS评分A组低于B组(P<0.05)。术后1个月HAMA、HAMD评分比较,A组优于B组(P<0.05)。术后3个月、6个月、9个月髋关节Harris评分相比较,A组显著高于B组(P<0.05)。术后1年2组患者髋关节Harris评分比较,差异无统计学意义(P>0.05)。结论老年股骨粗隆间骨折PFNA术后,早期给予体外冲击波干预治疗具有显著的效果,有效促进骨折愈合及功能恢复,能改善患者身心健康,并值得临床应用与推广。

Objective To investigate the effect of extracorporeal shock wave treatment(ESWT)on the elderly patients with femoral intertrochanteric fracture after PFNA.Methods 120 elderly patients with femoral intertrochanteric fracture after PFNA were retrospective analyzed.The patients were randomly divided into group A treated with shock wave after operation and group B treated with control wave(n=60).The fracture healing rate of the two groups at different time after operation was compared,and the VAS,HAMA,HAMD,Harris scores of the two groups after operation were compared.Results All patients were followed up for one year.The fracture healing rate of group A was higher than group B 1~3 months,3~6 months,6~9 months and 9~12 months after operation(P<0.05).The VAS score of group A was lower than that in group B in one month and two months after operation(P<0.05).One month after operation,the scores of HAMA and HAMD in group A were better than those in group B,and the difference was statistically significant(P<0.05).The Harris scores of hip joint in group A was significantly higher than those in group B at 3 months,6 months and 9 months after operation(P<0.05).There was no significant difference in Harris scores of hip joint between the two groups 1 year after operation(P>0.05).Conclusion After PFNA of femoral intertrochanteric fracture in the elderly,early treatment with extracorporeal shock wave intervention has a significant effects,improving the physical and mental health of patients,effectively promoting fracture healing and functional recovery,which is worthy of clinical application and promotion.