防旋型股骨近端髓内钉内固定术与人工股骨头置换术治疗高龄股骨粗隆间骨折患者的效果

Effect of Antirotation Proximal Femoral Intramedullary Nail Internal Fixation and Artificial Femoral Head Replacement in the Treatment of Elderly Patients with Intertrochanteric Femoral Fractures

目的:分析防旋型股骨近端髓内钉(PFNA)内固定术与人工股骨头置换术治疗高龄股骨粗隆间骨折患者的效果。方法:选取2022年1月—2023年12月兴义市人民医院收治的高龄股骨粗隆间骨折患者80例作为研究对象,随机分为对照组和观察组,各40例。对照组行人工股骨头置换术治疗,观察组行PFNA内固定术治疗。比较两组手术指标、并发症发生率、日常生活活动能力(ADL)评分及Harris评分。结果:观察组手术时间、术后下床活动时间、住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。治疗前,两组患者ADL、Harris评分比较,差异无统计学意义(P>0.05);治疗后,两组患者ADL、Harris评分均高于治疗前,观察组高于对照组,差异有统计学意义(P<0.05)。结论:PFNA内固定术和人工股骨头置换术治疗高龄股骨粗隆间骨折患者安全性较高,但PFNA内固定术的优势在于创伤性小、术中出血量少,可以提高患者的日常生活活动能力与髋关节功能,促进患者快速康复。

Objective:To analyze the efficacy of antirotation femoral proximal intramedullary nail(PFNA)internal fixation and artificial femoral head replacement in the treatment of elderly patients with intertrochanteric fractures.Methods:Eighty elderly patients with intertrochanteric fracture of femur treated in Xingyi People's Hospital from January 2022 to December 2023 were selected as the study objects,and randomly divided into control group and observation group,with forty cases in each group.The control group was treated with artificial femoral head replacement,the observation group was treated with PFNA internal fixation.The operative indexes,complication rate,activities of daily living(ADL)score and Harris score were compared between the two groups.Results:The operation time,postoperative activity time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,the difference was statistically significant(P<0.05);there was no significant difference in the incidence of complications between the two groups(P>0.05);before treatment,there was no significant difference in ADL and Harris scores between the two groups(P>0.05);after treatment,ADL and Harris scores in two groups were higher than before treatment,and observation group was higher than control group,the difference was statistically significant(P<0.05).Conclusion:PFNA internal fixation and artificial femoral head replacement are relatively safe in the treatment of elderly patients with intertrochanteric femoral fractures.However,PFNA internal fixation has the advantages of less trauma and less intraoperative blood loss,which can improve patients'activities of daily living and hip function,and promote rapid recovery of patients.