小切口辅助复位配合股骨近端防旋髓内钉内固定治疗老年股骨转子间骨折的效果

Effect of Small Incision Assisted Reduction Combined with Proximal Femoral Anti-Rotation Intramedullary Nail Internal Fixation in Treatment of Elderly Femoral Intertrochanteric Fracture

目的:分析小切口辅助复位配合股骨近端防旋髓内钉内固定治疗老年股骨转子间骨折的效果。方法:将2022年1月—2024年1月西安市北方医院收治的80例老年股骨转子间骨折患者随机分对照组(n=40,实施人工髋关节置换术治疗)和观察组(n=40,实施小切口辅助复位配合股骨近端防旋髓内钉内固定治疗)。比较两组患者手术指标、髋关节功能、疼痛情况、骨密度。结果:观察组手术时间、住院时间短于对照组,术中出血量、术后引流量少于对照组,首次下地行走时间、骨折愈合时间早于对照组(P<0.05)。术前,两组髋关节功能评分量表(Harris)、视觉模拟评分法(VAS)评分对比,无统计学差异(P>0.05);术后1周,两组Harris评分升高,VAS评分下降,且观察组改善幅度大于对照组(P<0.05)。术前,两组骨大粗隆、Ward三角区、股骨颈骨密度对比,无统计学差异(P>0.05);术后1周,两组骨大粗隆、Ward三角区、股骨颈骨密度升高,且观察组改善幅度大于对照组(P<0.05)。结论:小切口辅助复位配合股骨近端防旋髓内钉内固定治疗老年股骨转子间骨折的效果较好,可优化手术指标,减轻术后疼痛,改善患者髋关节功能、骨密度,促进患者康复。

Objective:To analyze the effect of small incision assisted reduction combined with proximal femoral anti-rotation intramedullary nail internal fixation in treatment of elderly femoral intertrochanteric fracture.Methods:Eighty elderly patients with intertrochanteric fracture of femur admitted to Xi'an North Hospital from January 2022 to January 2024 were randomly divided into control group(n=40,receiving artificial hip replacement treatment)and observation group(n=40,receiving small incision assisted reduction combined with proximal femoral anti-rotation intramedullary nail internal fixation treatment).The surgical indexes,hip joint function,pain and bone mineral density were compared between the two groups.Results:The operation time and the length of hospital stay in the observation group were shorter than those in the control group,the intraoperative blood loss and postoperative drainage volume in the observation group were less than those in the control group,and the time of first ambulation and fracture healing in the observation group were earlier than those in the control group(P<0.05).Before surgery,there was no statistically significant difference in the scores of hip joint function rating scale(Harris)and Visual Analogue Rating(VAS)between the two groups(P>0.05).On 1 week after surgery,the Harris score increased and the VAS score decreased in the two groups,and the improvement in the observation group was greater than that in the control group(P<0.05).Before surgery,there was no statistically significant difference in bone mineral density of greater trochanter,Ward triangle femoral neck between the two groups(P>0.05).On 1 week after surgery,the bone mineral density of greater trochanter,Ward triangle femoral neck in the two groups increased,and the improvement in the observation group was greater than that in the control group(P<0.05).Conclusion:Small incision assisted reduction combined with proximal femoral anti-rotation intramedullary nail internal fixation has a good effect in the treatment of elderly femoral intertrochanteric fracture,and can optimize surgical indicators,relieve postoperative pain,improve hip joint function and bone mineral density,and promote rehabilitation of patients.