采用PFNA手术治疗老年骨质疏松股骨粗隆间骨折的有效性观察分析

Effect Observation and Analysis of PFNA Surgery in Treatment of Femoral Intertrochanteric Fractures of Elderly with Osteoporosis

目的 探讨股骨近端防旋髓内钉(PFNA)手术治疗老年骨质疏松股骨粗隆间骨折的有效性。方法 对本院于2018年1月-2021年12月收治的306例骨质疏松股骨粗隆间骨折患者进行回顾性分析,以手术治疗方案的不同作为分组依据,154例采用PFNA手术治疗的患者归为研究组,152例经常规股骨近端钢板内固定手术治疗的患者则纳入常规组。记录并比较两组手术指标,同时对比其髋关节Harris评分,对手术优良率展开评估,观察术后并发症发生情况,随访1年,记录期间有无再发生骨折。结果 研究组术中失血量较常规组少,且术后首次下床时间、住院时间以及骨折愈合时间均较常规组短(P<0.05);研究组手术优良率较常规组高(P<0.05);研究组髋关节Harris各维度评分均比常规组高(P<0.05);研究组术后并发症发生率、骨折再发率均比常规组低(P<0.05)。结论 对老年骨质疏松股骨粗隆间骨折患者采用PFNA手术治疗,不仅有助于优化各项手术指标,而且可改善术后髋关节功能,手术效果确切,且术后并发症发生风险较低,可减少骨折再发率,实现对远期预后情况的改善,整体应用价值较高。

Objective To investigate effect of proximal femoral anti rotation intramedullary nail(PFNA)surgery for femoral intertrochanteric fractures of elderly with osteoporosis.Methods The paper reviewed and analyzed 306 elderly osteoporotic patients with femoral intertrochanteric fractures admitted to our hospital from January 2018 to December 2021.with grouping criteria of different surgical treatment schemes,154 cases treated with PFNA surgery were included in study group,while 152 cases treated with routine proximal femoral plate internal fixation surgery in routine group.Surgical indicators were recorded and compared,Harris hip joint scores were compared between two groups excellent and good rate of surgery was evaluated.Postoperative complications incidence was observed,with 1 year of followup,further fractures during the period were recorded.Results Study group had less intraoperative blood loss than routine group,first out of bed time,length of stay,fracture healing time was shorter than routine group(P<0.05).Excellent and good rate of surgery in study group was higher than routine group(P<0.05).Harris scores in all dimensions of hip joint in study group were higher than routine group(P<0.05).Incidence of postoperative complications and fracture recurrence in study group was lower than routine group(P<0.05).Conclusion PFNA surgery can optimize various surgical indicators,improve postoperative hip joint function of elderly osteoporotic patients with femoral intertrochanteric fractures,with accurate surgical effect,low risk of postoperative complications,can reduce recurrence rate of fractures,improve long-term prognosis,which has high overall application value.