股骨粗隆间骨折实施髓内钉固定技术的疗效分析

Efficacy analysis of intramedullary nail fixation technique for intertrochanteric fracture of the femur

目的探讨股骨粗隆间骨折实施髓内钉固定技术的疗效。方法100例股骨粗隆间骨折患者作为研究样本,按照随机数字表法将其分成研究组、对照组,各50例。两组均实施切开复位内固定术治疗,在内固定材料选择时,对照组选择锁定钢板,研究组选择髓内钉。对比两组手术情况,术后恢复时间,血清炎症因子指标,疼痛评分、髋关节功能评分,生活质量评分。结果研究组手术耗时(74.98±12.15)min较对照组的(92.73±15.62)min短(P<0.05),研究组术中失血量(153.12±31.08)ml少于对照组的(216.69±40.34)ml(P<0.05)。研究组术后初次离床活动、骨折愈合时间及住院天数分别为(4.91±1.03)d、(11.63±1.45)周、(10.04±1.98)d,均较对照组的(6.30±1.24)d、(14.07±1.91)周、(12.89±2.60)d短(P<0.05)。术后1 d,两组血清C反应蛋白和白细胞介素-6水平均较术前显著增高,而研究组血清C反应蛋白(5.89±1.06)mg/L和白细胞介素-6(25.46±3.75)pg/ml均比对照组的(7.02±1.27)mg/L、(29.69±3.83)pg/ml低(P<0.05)。术后3个月,两组疼痛评分均较术前显著降低、髋关节功能评分与术前相比均显著增高,而研究组疼痛评分(2.63±0.61)分较对照组的(3.49±0.72)分低、髋关节功能评分(90.65±7.02)分则较对照组的(81.42±7.38)分高(P<0.05)。术后3个月,两组生活质量中生理、心理、环境、社会关系评分与术前相比均显著增高,而研究组均较对照组高(P<0.05)。结论股骨粗隆间骨折患者行切开复位内固定术治疗时选择髓内钉作为内固定物可取得比锁定钢板更好的手术效果,髓内钉固定不仅可减轻手术创伤,减少术后炎性因子渗出,还可加快患者术后康复进程,促使其骨折更快愈合,有利于更好地改善髋关节功能,减轻疼痛感,提升生活质量。

Objective To explore the efficacy of intramedullary nail fixation technique for intertrochanteric fracture of the femur.Methods 100 cases of intertrochanteric fracture of the femur were studied and divided into a study group and a control group according to random number table method,each with 50 cases.Both groups underwent open reduction and internal fixation surgery.When selecting internal fixation materials,the control group chose locking steel plates,while the study group chose intramedullary nails.The surgical situation,postoperative recovery time,serum inflammatory factor indicators,pain scores,hip joint function scores,and quality of life scores were compared between the two groups.Results The study group had shorter operation time of(74.98±12.15)min than(92.73±15.62)min in the control group(P<0.05).The study group had less intraoperative blood loss of(153.12±31.08)ml than(216.69±40.34)ml in the control group(P<0.05).The postoperative first ambulatory activity,fracture healing time,and hospitalization days in the study group were(4.91±1.03)d,(11.63±1.45)weeks and(10.04±1.98)d,which were shorter than(6.30±1.24)d,(14.07±1.91)weeks and(12.89±2.60)d in the control group(P<0.05).1 d after surgery,the levels of serum C-reactive protein and interleukin-6 in both groups were significantly higher than those before surgery;the study group had serum C-reactive protein of(5.89±1.06)mg/L and interleukin-6 of(25.46±3.75)pg/ml,which were lower than(7.02±1.27)mg/L and(29.69±3.83)pg/ml in the control group(P<0.05).3 months after surgery,the pain score in both groups were significantly lower than that before surgery,and the hip function score was significantly higher than that before surgery;the study group had lower pain score of(2.63±0.61)points than(3.49±0.72)points in the control group,and higher hip function score of(90.65±7.02)points than(81.42±7.38)points in the control group(P<0.05).3 months after surgery,the quality of life scores of physiology,psychology,environment and social relations in both groups were significantly increased compared with those before surgery,while the study group was higher than the control group(P<0.05).Conclusion When treating intertrochanteric fractures of the femur with open reduction and internal fixation,choosing intramedullary nails as internal fixators can achieve better surgical results than locking steel plates.Intramedullary nail fixation not only reduces surgical trauma,reduces postoperative inflammatory factor leakage,but also accelerates the patient's postoperative recovery,promotes faster fracture healing,and is conducive to better improving hip joint function,reducing pain,and improving quality of life.