内固定手术中应用股骨近端防旋髓内钉治疗老年骨质疏松性股骨粗隆间骨折的效果分析

Effectiveness of proximal femoral anti rotation intramedullary nail in the treatment of elderly osteoporotic intertrochan⁃teric fractures during internal fixation surgery

目的:探讨在内固定手术中应用股骨近端防旋髓内钉(PFNA)对老年骨质疏松性股骨粗隆间骨折治疗的作用。方法:自2018年1月起,在毕节市赫章县人民医院收集发生股骨粗隆间骨折并伴骨质疏松症的老年患者为研究对象。截至2023年12月,共收集150例,随机分成对照组和研究组,每组75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PFNA。比较两组手术情况、术后恢复时间、术后并发症发生率。结果:研究组手术时间及术后恢复时间短于对照组,术中失血量少于对照组(P<0.001);两组术后并发症发生率对比,无统计学差异(P>0.05)。结论:在伴有骨质疏松症的股骨粗隆间骨折老年人患者手术治疗时,选择PFNA作为内固定材料,有助于减轻手术创伤,缩短手术时间,加快术后康复,且安全性较高。

Objective:To explore the role of proximal femoral anti rotation intramedullary nail(PFNA)in the treatment of elderly osteoporotic intertrochanteric fractures during internal fixation surgery.Methods:Since January 2018,elderly patients who underwent intertrochanteric femur fracture with osteoporosis were collected from the Bijie Hezhang County People's Hospital as study subjects.As of December 2023,a total of 150 cases were collected and randomly divided into the control group and the study group,with 75 cases in each group.Both groups were treated with cut-and-replace internal fixation,and in the choice of internal fixation materials,locking steel plate was chosen for the control group and PFNA for the study group.Comparison of the two groups'surgical conditions,postoperative recovery time,and postoperative complication rate.Results:The study group had shorter surgical time and postoperative recovery time compared to the control group,and their intraoperative blood loss was lower than that of the control group(P<0.001);the difference of the incidence rate of postoperative complications between the two groups was statistically not significant when comparing the rates of postoperative complications(P>0.05).Conclusion:When selecting PFNA as the internal fixation material for surgical treatment of intertrochanteric fractures in elderly patients with osteoporosis,it has a better effect than locking steel plates,can reduce surgical trauma,shorten surgical time,accelerate postoperative recovery process,and has higher safety.