闭合复位PFNA内固定治疗老年股骨粗隆部骨折的效果及对骨折愈合、骨代谢指标的影响

Effect of Closed Reduction And PFNA Internal Fixation on Femoral Intertrochanteric Fracture in the Elderly And its Influence on Fracture Healing And Bone Metabolism Index

目的探究闭合复位股骨近端螺旋刀片抗旋髓内钉(PFNA)内固定治疗对于老年股骨粗隆部骨折的临床效果及对骨折愈合、骨代谢指标的影响。方法选择2021年12月至2022年12月浦江县人民医院骨二科收治的60例老年股骨粗隆部骨折患者为研究对象,随机分为两组。对照组给予动力髋螺钉治疗,研究组给予闭合复位PFNA内固定治疗。比较两组骨代谢、手术指标、临床疗效与术后并发症。结果研究组治疗后血清BGP、BMP-2、BALP水平均高于对照组,P<0.05。研究组住院时间、手术时间、骨折愈合时间均短于对照组,术中出血量少于对照组,P<0.05。研究组术后并发症总发生率低于对照组,P<0.05。研究组治疗总有效率明显高于对照组,P<0.05。结论闭合复位PFNA内固定治疗老年股骨粗隆部骨折患者可提升临床疗效,降低术后并发症发生率,改善骨代谢指标和手术情况,加速患者康复。

Objective:To explore the clinical effect of closed reduction and internal fixation with proximal femoral spiral blade anti-rotation intramedullary nail(PFNA)on senile femoral intertrochanteric fracture and its influence on fracture healing and bone metabolism index.Methods:From December 2021 to December 2022,60 elderly patients with femoral intertrochanteric fracture were selected as the research object and randomly divided into two groups.The control group was treated with dynamic hip screw,and the study group was treated with closed reduction and PFNA internal fixation.Bone metabolism,surgical indexes,clinical efficacy and postoperative complications were compared between the two groups.Results:After treatment,the levels of serum BGP、BMP-2 and BALP in the study group were higher than those in the control group,P<0.05.The hospitalization time,operation time and fracture healing time of the study group were shorter than those of the control group,and the amount of bleeding during operation was less than that of the control group,P<0.05.The total incidence of postoperative complications in the study group was lower than that in the control group,P<0.05.The total effective rate of treatment in the study group was significantly higher than that in the control group,P<0.05.Conclusion:Closed reduction and PFNA internal fixation can improve the clinical efficacy,reduce the incidence of postoperative complications,improve the bone metabolism index and surgical conditions,and accelerate the rehabilitation of elderly patients with femoral intertrochanteric fracture.