透视牵引下PFNA内固定术治疗股骨粗隆间骨折的临床价值分析

Analysis of the Clinical Value of PFNA Instrumentation Under Fluoroscopic Traction for Intertrochanteric Femoral Fractures

目的:比较股骨粗隆间骨折患者选择髋关节置换术、透视牵引下股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)内固定术治疗方案的价值。方法:选择2020年3月~2023年2月在本院接受治疗的80例股骨粗隆间骨折患者作为研究对象,按照随机数字表法分为两组,参照组(40例)以髋关节置换术为主导,试验组(40例)以透视牵引下PFNA内固定术为主导,对比两组患者手术相关指标及并发症发生情况。结果:80例患者术后随访6个月,收集临床数据进行统计分析。与试验组相对比,参照组术后下床时间更早,术后1周VSA评分、术后1月、3月Harris评分更低(P<0.05);术后切口、术中出血量对比,试验组数值显著高于参照组(P<0.05);两组手术时间、住院时间及术后6个月Harris评分无显著差异(P>0.05)。结论:髋关节置换术用于股骨粗隆间骨折治疗,可加速患者的愈合速度,降低患者术后并发症的发生,改善患者髋关节功能,透视牵引下PFNA内固定术具有切口小,术中出血少等优点,但髋关节功能恢复更慢。

Objective:To compare the value of hip replacement surgery and proximal femoral anti rotation intramedullary nail(PFNA)internal fixation under fluoroscopy traction in patients with intertrochanteric fractures of the femur.Methods:80 patients with intertrochanteric fractures of the femur who received treatment in our hospital from March 2020 to February 2023 were selected as the study subjects.They were randomly divided into two groups using a random number table method.The control group(40 cases)was dominated by hip replacement surgery,while the experimental group(40 cases)was dominated by PFNA internal fixation surgery under fluoroscopy traction.The surgical related indicators and incidence of complications were compared between the two groups of patients.Results:80 patients were followed up for 6 months after surgery,and clinical data was collected for statistical analysis.Compared with the experimental group,the reference group had earlier postoperative bedtime,lower VSA scores at 1 week and Harris scores at 1 and 3 months after surgery(P<0.05);The comparison of postoperative incision and intraoperative bleeding showed that the experimental group had significantly higher values than the control group(P<0.05);There was no significant difference in surgical time,hospital stay,and Harris score between the two groups at 6 months after surgery(P>0.05).Conclusion:Hip replacement surgery for the treatment of intertrochanteric fractures of the femur can accelerate the healing speed of patients,reduce the occurrence of postoperative complications,and improve hip joint function.PFNA internal fixation under fluoroscopy traction has the advantages of small incision and less intraoperative bleeding,but the recovery of hip joint function is slower.