应用椎体成形工具制作通道植骨联合股骨近端防旋髓内钉治疗老年股骨转子间骨折的疗效分析

Analysis of the Efficacy of Bone Grafting Through the Channel by Vertebroplasty Instrument Combined with PFNA in the Treatment of Senile Intertrochanteric Fracture

目的:探讨应用椎体成形工具制作通道下植入人工骨联合股骨近端防旋髓内钉(PFNA)内固定治疗老年股骨转子间骨折的效果。方法:将2020年6月~2021年12月老年股骨转子间骨折患者69例分为两组(PFNA+植骨组及单纯PFNA组),两组患者均行闭合复位股骨近端抗旋髓内钉内固定治疗,PFNA+植骨组在PFNA内固定后经过通道置入人工骨植骨,比较两组手术时间、术中出血量及骨折愈合时间,术后3个月患者满意度及术后并发症(负重后髋内翻)发生率。结果:两组69例患者获12~18个月(平均15个月)随访,两组术中出血量、手术时间比较差异无统计学意义(P>0.05),骨折愈合时间比较差异有统计学意义(P<0.05)。两组术后3个月患者满意度及并发症发生率比较有统计学意义(P<0.05)。结论:老年股骨转子间骨折髓内固定治疗可取得良好的效果,术中应用椎体成形工具制作通道植骨微创简单,对于严重骨质疏松患者起到更好的效果。

Objective:To explore the effect of implanting artificial bone through the channel by vertebroplasty instrument combined with minimally invasive proximal femoral nail antirotation(PFNA)internal fixation for senile intertrochanteric fracture of femur.Methods:69 elderly patients with intertrochanteric fracture of femur from June 2020 to December 2021 were divided into two groups.Patients were treated with PFNA and bone grafting combined with PFNA internal fixation respectively,and blood loss,operation time and clinical union time were compared between the two groups,patients’satisfaction at 3 months after operation,and incidence of complications(coxa vara after weight bearing)were compared.Results:69 patients in the two groups were followed up for 12 to 18 months(mean 15 months).There was no statistically significant difference in intraoperative blood loss and operation time between the two groups(P>0.05),the difference in clinical union time was statistically significant(P<0.05).There were statistically significant differences in patient satisfaction and complication incidence at 3 months after surgery(P<0.05).Conclusion:Intramedullary fixation has achieved good results in the treatment of intertrochanteric fractures of the femur in the elderly,and implanting artificial bone through the channel by vertebroplasty instrument is minimally invasive and simple during operation,which has a better effect for patients with severe osteoporosis.