髓外与髓内固定系统治疗老年股骨转子间骨折疗效分析

Efficacy of Extramedullary and Intramedullary Fixation Systems in the Treatment of Elder⁃ly Intertrochanteric Fracture of Femur

目的探讨髓内外固定系统治疗老年骨转子间骨折的临床疗效。方法选择医院2019年1月至2020年3月收治的老年股骨转子间骨折患者110例,采用随机数字表法将患者分为对照组和观察组,各55例。对照组患者采用动力髋螺钉(DHS)髓外固定治疗,观察组患者采用股骨近端防旋髓内钉(PFNA)髓内固定治疗。结果治疗后1,3,6个月后,观察组患者的Harris评分均显著高于对照组(P<0.05);观察组患者的优良率显著高于对照组(P<0.05)。观察组患者愈合时间、术中出血量及手术时间均显著少于对照组(P<0.05)。结论与DHS髓外固定比较,PFAN髓内固定治疗老年股骨转子间骨折患者的疗效较好,具有手术时间短、愈合时间快的优点,可改善患者的髋关节功能。

Objective To investigate the clinical efficacy of extramedullary and intramedullary fixation systems in the treatment of intertrochanteric fracture of femur in the elderly patients.Methods A total of 110 elderly patients with intertrochanteric fracture of femur admitted to the hospital from January 2019 to March 2020 were selected and randomly divided into the control group and the observation group by the random number table method,with 55 patients in each group.The patients in the control group were treated with dynamic hip screw(DHS)extramedullary fixation,while the patients in the observation group were treated with proximal femoral nail antirotation(PFNA)intramedullary fixation.Results After one,three and six months of treatment,the Harris score in the observation group was significantly higher than that in the control group(P<0.05).The excellent and good rate in the observation group was significantly higher than that in the control group(P<0.05).The healing time,intraoperative bleeding amount,and surgical time in the observation group was significantly less than that in the control group(P<0.05).Conclusion Compared with DHS extramedullary fixation,PFAN intramedullary fixation is more effective in the treatment of intertrochanteric fracture of femur in the elderly,it has the advantages of short surgical time and fast healing time,which can improve the hip joint function of patients.