远端锁钉应用对稳定股骨粗隆间骨折患者治疗效果及并发症的影响

Effect of Distal Locking Nail Application on the Treatment Effect and Complications in Patients with Stabilized Intertrochanteric Femoral Fractures

目的:探讨远端锁钉应用对稳定股骨粗隆间骨折患者的治疗效果及并发症影响,为临床提供参考。方法:选取2019年1月—2021年1月泉州市中医院收治的85例稳定股骨粗隆间骨折患者作为研究对象,所有患者均使用Gamma髓内钉内固定治疗,根据患者是否应用远端锁定螺钉内固定治疗分为远端锁定组(n=45)和未远端锁定组(n=40)。对比两组患者的手术失败率与并发症发生率,不同时间Harris评分与VAS评分。结果:未远端锁定组患者并发症发生率低于远端锁定组,差异有统计学意义(X^(2)=4.722,P<0.05);两组患者在手术后2个月Harris评分均升高,远端锁定组患者低于未远端锁定组,差异有统计学意义(t=17.779,P<0.05);两组患者术后3 d VAS评分均降低,且未远端锁定组患者低于远端锁定组,差异有统计学意义(t=26.998,P<0.05)。结论:稳定股骨粗隆间骨折患者在Gamma髓内钉内固定治疗基础上,不应用远端锁定螺钉内固定手术成功率较高,且能够降低患者并发症发生率,减轻疼痛水平,提升患者髋关节功能。

To investigate the effect of distal locking nail application on the treatment outcome and complications in patients with stabilized intertrochanteric fractures of the femur,to provide clinical reference.Methods:85 patients with stabilized intertrochanteric femur fractures admitted to the hospital from January 2019 to January 2021 were selected as the subjects of this study,and all of them were treated with Gamma intramedullary nails for internal fixation,and were divided into distal locking group(n=45)and undistal locking group(n=40)according to whether or not distal locking screw internal fixation treatment was applied.Surgical failure and complication rates,Harris scores and VAS scores at different times were compared between the two groups.Results:The complication rate of patients in the undistal locking group was lower than that of patients in the distal locking group,and the difference was statistically significant(X^(2)=4.722,P<0.05).Both groups showed elevated Harris scores 2 months after surgery,and the distal locking group was lower than the non-distal locking group,with a statistically significant difference(t=17.779,P<0.05).VAS scores were lower in both groups at 3 d postoperatively,and were lower in the undistal locking group than in the distal locking group,with a statistically significant difference(t=26.998,P<0.05).Conclusion:On the basis of Gamma intramedullary nail internal fixation for patients with stabilized intertrochanteric femur fracture,applying distal locking screw internal fixation in creases the success rate of the operation,and it can reduce the incidence of patients’complications,alleviate the level of pain,and improve the function of patients’hip joints.