抗骨质疏松药物联合手术治疗老年骨质疏松性股骨粗隆间骨折疗效观察

Treatment of osteoporotic intertrochanteric fracture of femur with anti-osteoporosis drugs combined with operation in senile patients

目的探讨抗骨质疏松药物联合手术治疗老年骨质疏松性股骨粗隆间骨折的临床效果。方法选取解放军中部战区空军医院48例老年骨质疏松性股骨粗隆间骨折患者,随机分为对照组与观察组,各24例,观察组采用抗骨质疏松药物联合骨折闭合复位股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)内固定,对照组采用口服碳酸钙D3(钙尔奇D)片加骨折闭合复位PFNA内固定。比较2组患者骨折愈合时间、完全负重活动时间,内固定器松动、移位情况。同时比较2组术前及术后6个月疼痛视觉模拟评分法(visual analogue scale,VAS)评分、Harris评分及骨密度值。结果观察组骨折愈合时间、完全负重活动时间、术后6个月的VAS评分、Harris评分、骨密度值及内固定松动、移位情况均优于对照组,差异有统计学意义(P<0.05)。结论抗骨质疏松药物联合手术治疗老年骨质疏松性股骨粗隆间骨折可增加患者骨密度,有效对抗骨质疏松,促进骨折早期愈合,降低内固定松动发生率,使患者可尽早下地行功能锻炼,且药物安全性良好。

Objective To investigate the clinical effect of anti-osteoporosis drugs combined with surgical treatment for elderly patients with osteoporotic intertrochanteric fracture of femur.Methods A total of 48 elderly patients with osteoporotic intertrochanteric femur were randomly divided into control group and observation group(=24).The observation group was treated with anti-osteoporosis drugs combined with closed reduction of fracture PFNA internal fixation,while the control group was treated with oral Calorci D tablet plus closed reduction of fracture PFNA internal fixation.The treatment course of the two groups was 4 months,and the fracture healing time,complete weight-bearing activity time,looseness and displacement of internal fixator were compared between the two groups.Visual analog score,Harris score and bone mineral density before and 6 months after surgery.Results Fracture healing time,total weight-bearing activity time,VAS score,Harris score,bone mineral density value and internal fixation loosening and displacement in the observation group were better than those in the control group,with statistical significance(<0.05).Conclusion Anti-osteoporosis drugs combined with surgery for the treatment of osteoporotic femoral trochanteric fracture in the elderly can increase the bone density of patients,effectively fight against osteoporosis,promote early fracture healing,reduce the incidence of internal fixation loosening,patients can go to the ground early functional exercise,good safety of drugs.