PFNA联合骨水泥注入治疗老年性股骨粗隆间骨折

PFNA Combined with Bone Cement Injection in the Treatment of Femoral Intertrochanteric Fracture In the Elderly

目的探讨PFNA联合骨水泥注入治疗老年性股骨粗隆间骨折的安全性与临床疗效。方法选取我院老年性股骨粗隆间骨折患者,进行随机分组,第1组:行DHS内固定术,第2组:行PFNA内固定联合骨水泥注入,对手术安全性与近期疗效及随访远期疗效进行评定。结果临床疗效方面,第2组患者术后3个月Harris评分85.41±6.7分,显著高于第1组(P<0.001),随着术后时间的延长,第2组患者Harris评分在术后随访各个时间节点均高于第1组,且随术后时间延长,评分差异不明显,基本维持稳定。且第2组患者住院时间仅为(12.21±5.1)d显著少于1组患者,具有疗效起效快,且疗效持久的优势。临床安全性评估方面,第2组患者手术耗时(64.27±11.2)min,术中出血量(150.6±31.7)ml也明显优于第1组。结论 PFNA内固定联合骨水泥较动力髋螺钉(DHS)内固定更能有效稳定骨折股骨,预防进一步骨折,且临床具有良好安全性,是治疗老年性股骨粗隆间骨折更有效、安全的治疗方法。

Objective To investigate the safety and clinical efficacy of PFNA combined with bone cement injection in the treatment of femoral intertrochanteric fractures in the elderly.Methods In our hospital senile femoral intertrochanteric fracture patients were randomly divided into first groups:DHS,internal fixation,second patients underwent internal fixation with PFNA bone cement injection,surgical safety assessment and follow-up efficacy and long-term efficacy.Results The clinical efficacy,second patients 3 months after surgery,Harris score was 85.41±6.7,significantly higher than the first group(P<0.001),with the extension of time after surgery,the Harris score of the second groups in the postoperative follow-up time of each node are higher than the first group,and with the extension of time after surgery.The score was not significantly different to maintain the basic stability.And the second groups of patients in hospital time only(12.21±5.1) d significantly less than the first groups of patients with curative effect fast,and the effect of lasting advantage.Clinical safety evaluation,time-consuming operation of second groups(64.27±11.2) min and the amount of bleeding(150.6±31.7) ml is obviously better than the first groups.Conclusion PFNA internal fixation combined with bone cement with dynamic hip screw(DHS) fixation is more effective and stable fracture of femur,prevent further fractures,and has good clinical safety,is the treatment of senile unstable treatment more effective and safe for treatment of senile femoral intertrochanteric fracture