股骨近端防旋髓内钉治疗股骨转子间骨折的效果

Effect of Proximal Femoral Nail Antirotation in the Treatment of Femoral Intertrochanteric Fractures

目的:探究与近端锁定钢板相比,股骨近端防旋髓内钉(PFNA)对股骨转子间骨折患者的效果。方法:将在瑞昌市中医医院2020年1月—2023年1月进行治疗的88例股骨转子间骨折患者按照随机数字表法分为常规组和研究组,各44例。常规组采用股骨近端锁定钢板治疗,研究组采用PFNA治疗。比较研究组和常规组患者手术时间、术中出血量及髋关节恢复情况,并比较术后6个月两组患者尖顶距(TAD),分析两组并发症及术后骨折不愈合率。结果:研究组手术时间短于常规组,术中出血量少于常规组(P<0.05);研究组术后1个月髋关节恢复优良率高于常规组(P<0.05);两组术后6个月TAD均高于术前,且研究组更高(P<0.05);两组术后6个月并发症发生率比较,研究组低于常规组(P<0.05);研究组骨折不愈合率低于常规组(9.09%vs 25.00%)(P<0.05)。结论:PFNA对促进股骨转子间骨折患者的髋关节功能及术后TAD的恢复效果较好,相较于股骨近端锁定钢板,能降低术中出血量、加快手术进程,且术后并发症少。

Objective:To investigate the efficacy of proximal femoral nail antirotation(PFNA)in patients with femoral intertrochanteric fractures compared with proximal locking plate.Method:A total of 88 patients with femoral intertrochanteric fractures treated in Ruichang Hospital of Traditional Chinese Medicine from January 2020 to January 2023 were divided into conventional group and study group according to the random number table method,with 44 cases in each group.The conventional group was treated with proximal femoral locking plate,and the study group was treated with PFNA.The operative time,intraoperative blood loss,and hip recovery were compared between the study group and the conventional group,and the tip apex distance(TAD)of the two groups were compared 6 months after surgery,and the complications and postoperative fracture nonunion rate of the two groups were analyzed.Result:The operation time in the study group was shorter than that in the conventional group,and the intraoperative blood loss was less than that in the conventional group(P<0.05),the excellent rate of hip joint recovery in the study group at one month after surgery was higher than that in the conventional group(P<0.05),the TAD in the two groups at 6 months after surgery were higher than those before operation,and the TAD in the study group was higher(P<0.05),the incidence of complications in the study group was lower than that in the conventional group(P<0.05),and the fracture nonunion rate in the study group was lower than that in the conventional group(9.09%vs 25.00%)(P<0.05).Conclusion:PFNA is effective in promoting hip function and TAD recovery in patients with intertrochanteric fracture,compared with proximal femoral locking plate,PFNA can reduce intraoperative blood loss,speed up the surgical process,and reduce postoperative complications.