股骨近端防旋髓内钉结合加速康复理念在Evans-JensenⅤ型股骨转子间骨折治疗中的应用效果

Effect of Proximal Femoral Anti-rotation Intramedullary Nail Combined with Enhanced Rehabilitation in the Treatment of Evans-Jensen Type V Femoral Intertrochanteric Fracture

目的 探究股骨近端防旋髓内钉联合加速康复理念在Evans-JensenⅤ型股骨转子间骨折治疗中的临床效果。方法 选取2021年7月—2023年10月南宁市第三人民医院骨科住院确诊为Evans-JensenⅤ型股骨转子间骨折的80例患者为研究对象,按治疗方法的不同分为对照组与观察组,各40例。对照组采用股骨近端锁定加压钢板,观察组采用股骨近端防旋髓内钉+加速康复理念。比较两组术中与术后指标(术中出血量、手术时间、术后下床活动时间、骨折愈合时间、术后1年颈干角丢失)、Harris评分及并发症发生情况。结果 观察组术中与术后指标、Harris评分明显优于对照组,差异有统计学意义(P均<0.05)。观察组并发症总发生率为5.00%(2/40),低于对照组的20.00%(8/40),差异有统计学意义(χ^(2)=4.114,P<0.05)。结论 在Evans-JensenⅤ型股骨转子间骨折患者中应用股骨近端防旋髓内钉联合加速康复理念,效果显著,能促进髋关节功能的良好恢复,具有较高的安全性。

Objective To explore the clinical effect of proximal femoral anti-rotation intramedullary nail combined with enhanced rehabilitation in the treatment of Evans-Jensen type V femoral intertrochanteric fracture.Methods A total of eighty patients diagnosed with Evans-Jensen type V intertrochanteric fracture admitted to the Department of Orthopedics of Nanning Third People's Hospital from July 2021 to October 2023 were selected as the study objects and divided into control group and observation group according to different treatment methods,with forty cases in each group.The control group was treated with proximal femoral locking compression plate,and the observation group was treated with proximal femoral anti-rotation intramedullary nail +enhanced rehabilitation concept.Compared two groups of intraoperative and postoperative indexes(intraoperative blood loss,operation time,postoperative ambulation time,fracture healing time,neck-shaft angle loss 1year after operation),Harris score and complications.Results The intraoperative and postoperative indexes and Harris scores of the observation group were significantly better than those of the control group,and the differences were statistically significant(all P<0.05).The total incidence of complications in the observation group was 5.00%(2/40),which was lower than 20.00%(8/40) in the control group,and the difference was statistically significant(χ^(2)=4.114,P<0.05).ConclusionI n patients with Evans-Jensen type V intertrochanteric fracture of femur,proximal femoral anti-rotation intramedullary nail combined with the concept of enhanced rehabilitation has a remarkable effect,and can promote good recovery of hip function with high safety.