穿刺点微切口PFNA治疗骨质疏松性股骨粗隆骨折疗效分析

Efficacy Analysis of Puncture Point Microincision PFNA for Treatment of Osteoporotic Femoral Trochanteric Fractures

目的针对骨质疏松并发股骨粗隆骨折的患者,探讨穿刺点微切口股骨近端防旋髓内钉的疗效。方法回顾性选取2020年6月—2023年1月徐州市矿山医院骨科行股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)手术的35例患者的临床资料。根据切口差异分为观察组(n=18)和对照组(n=17)。观察组行穿刺点微切口,对照组行常规大切口。比较两组手术相关情况、并发症、髋关节功能评分、术后疼痛情况。结果观察组手术耗时(57.16±9.43)min、手术过程中出血量(132.43±16.82)mL、切口尺寸(2.89±0.56)cm和站立活动时间(8.56±2.86)d均明显优于对照组,差异有统计学意义(t=5.489、5.714、16.190、3.694,P均<0.05)。两组术后并发症发生率比较,差异有统计学意义(P均<0.05)。两组术后髋关节功能比较,差异无统计学意义(P>0.05)。观察组疼痛评分低于对照组,差异有统计学意义(P<0.05)。结论对骨质疏松性股骨粗隆间骨折患者来说,穿刺点微切口PFNA能够减小刀口长度,有效减少手术所需要的时间和出血量,改善术后疼痛,有利于患者提前下床活动,降低术后卧床并发症的发生。

Objective To investigate the efficacy of puncture point microincision proximal femoral nail antirotation for patients with osteoporosis complicating femoral trochanteric fracture.Methods Clinical data of 35 patients undergoing Proximal Nail Antirotation(PFNA)surgery in the Department of Orthopedics,Xuzhou Mine Hospital from June 2020 to January 2023 were retrospectively selected.They were divided into observation group(n=18)and control group(n=17).The observation group underwent a microincision at the puncture point,and the control group underwent a con⁃ventional large incision.The operative conditions,complications,hip function score and postoperative pain were com⁃pared between the two groups.Results The observation group was better than the control group in terms of time taken for surgery(57.16±9.43)min,bleeding during the operation was(132.43±16.82)mL,the incision size(2.89±0.56)cm and time to standing activity(8.56±2.86)d,the differences were statistically significant(t=5.489,5.714,16.190,3.694,all P<0.05).There was statistically significance difference in the incidence of postoperative complications be⁃tween the two groups(P<0.05).There was no statistically significant difference in postoperative hip function between the two groups(P>0.05).The pain score of the observation group was lower than that of the control group,the differ⁃ence was statistically significant(P<0.05).Conclusion For patients with osteoporotic intertrochanteric fractures of fe⁃mur,micro-incision PFNA can reduce the length of the incision,effectively reduce the time required for surgery and the amount of blood loss,improve postoperative pain,facilitate patients to get out of bed in advance,and reduce the occurrence of postoperative bed complications.