PFNA对股骨粗隆间骨折术后步态分析的应用研究

The Application of PFNA to Gait Analysis of Femoral Intertrochanteric Fracture after Operation

目的探讨应用PFNA治疗股骨粗隆间骨折患者术后步态的疗效分析。方法选择河北省沧州中西医结合医院2015年5月—2016年3月收治的EvansⅡ~Ⅳ型股骨粗隆间骨折的患者60例,年龄58~83岁,男24例,女性36例,采用PFNA进行手术治疗,术前、术后进行VAS评分,术后6周内患肢部分负重,6周后拄拐全负重活动,术后6个月、1年行步态分析,记录相关数据。结果随访时间6个月~1年,随访患者52例,6例患者出院后因内科疾病死亡,2例失访,术后患者伤口一期愈合,1例出现内固定失效。术前VAS评分(8.46±1.61)分,术后3 d VAS评分(3.14±2.06)分,比较差异有统计学意义,6个月步态分析20例患者步态接近正常,1年后步态分析40例接近正常。结论 PFNA内固定治疗股骨粗隆间骨折在临床上取得了相对满意的效果,能减轻术后疼痛程度,创伤小,并发症少,较快恢复正常的步态。

Objective To explore the application of gait analysis of curative effect of PFNA in treatment of femoral intertrochanteric fracture patients after operation.Methods 60 cases of patients with type Ⅳ fractures of femoral intertrochanteric combined with the hospital in May 2015 to March 2016 months Evans Ⅱ-Hebei province Cangzhou traditional Chinese medicine and Western medicine,aged 58-83 years old,male 24 cases,female 36 an example,using PFNA for surgical treatment,preoperative and postoperative VAS score,limb weight-bearing within 6 weeks after surgery,6weeks after the crutch full weight-bearing activities,after in six mohths,analysis of gait for 1 years,recording the data.Results the follow-up time in June-2 years follow-upin 52 cases,6 patients were discharged after medical diseases,2cases were lost,postoperative wound healing,1 cases of internal fixation failure.Preoperative VAS score(8.46±1.61)points,after 3 days of VAS score(3.14±2.06)points,there was statistically significant difference in six mohths,gait analysis of 20 cases the gait is close to normal,1 years after the gait analysis of 40 cases of near normal.Conclusion:achieved relatively satisfactory clinical effect of PFNA internal fixation for intertrochanteric fracture,can reduce postoperative pain,less trauma,fewer complications,faster recovery of normal gait.