PFNA治疗老年股骨粗隆间骨折患者的安全性分析
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摘要
目的研究老年股骨粗隆间骨折采用股骨近端防旋髓内钉内固定手术治疗的效果。方法方便选取2016年5月—2018年5月在该院就诊的76例老年股骨粗隆间骨折患者分成对照组(38例)和治疗组(38例)。对照组采用股骨近端髓内钉内固定手术治疗;治疗组采用股骨近端防旋髓内钉内固定手术治疗。结果治疗组总有效率达到94.7%,对照组76.3%(χ~2=4.47,P<0.05);手术前后髋关节功能Harris评分和生活质量评分水平的改善效果优于对照组;住院治疗时间(13.54±2.59)d、术后完全负重时间(92.13±10.76)d、股骨功能完全恢复时间(97.86±20.47)d短于对照组(18.73±2.16)d、(118.75±12.94)d、(123.40±24.18)d(t=13.526 8,t=30.0428,t=31.240 6);术后并发症仅有出现2例,少于对照组的8例(χ~2=4.41,P<0.05)。结论老年股骨粗隆间骨折患者采用股骨近端防旋髓内钉技术实施内固定手术治疗,能够大幅度改善髋关节功能和生活质量,缩短治疗和恢复时间,减少并发症,使治疗效果提升。
Objective To study the effect of intramedullary nail fixation with internal fixation of the femoral intertrochanteric fracture. Methods 76 elderly patients with intertrochanteric fractures who were convenient treated in our hospital from May 2016 to May 2018 were divided into control group(38 cases) and treatment group(38 cases). The control group was treated with internal fixation of the proximal femur and intramedullary nailing. The treatment group was treated with internal fixation of the proximal femur and intramedullary nail. Results The total effective rate of the treatment group was 94.7%,and the control group was 76.3%(χ~2=4.47, P<0.05). The improvement of hip function Harris score and quality of life score before and after operation was better than that of the control group; hospitalization time(13.54± 2.59)d, total weight-bearing time(92.13±10.76)d, complete recovery time of femur function(97.86±20.47)d was shorter than that of the control group[(18.73±2.166)d,(118.75 ±12.946)d,(123.40 ±24.186)d,(t =13.526 8, t =30.042 8, t =31.240); only 2 cases of postoperative complications, less than 8 cases of the control group(χ~2= 4.41, P<0.05). Conclusion Elderly patients with intertrochanteric fractures undergoing internal fixation with proximal femoral anti-rotation intramedullary nailing can significantly improve hip function and quality of life, shorten treatment and recovery time, reduce complications, and improve treatment.
Objective To study the effect of intramedullary nail fixation with internal fixation of the femoral intertrochanteric fracture. Methods 76 elderly patients with intertrochanteric fractures who were convenient treated in our hospital from May 2016 to May 2018 were divided into control group(38 cases) and treatment group(38 cases). The control group was treated with internal fixation of the proximal femur and intramedullary nailing. The treatment group was treated with internal fixation of the proximal femur and intramedullary nail. Results The total effective rate of the treatment group was 94.7%,and the control group was 76.3%(χ~2=4.47, P<0.05). The improvement of hip function Harris score and quality of life score before and after operation was better than that of the control group; hospitalization time(13.54± 2.59)d, total weight-bearing time(92.13±10.76)d, complete recovery time of femur function(97.86±20.47)d was shorter than that of the control group[(18.73±2.166)d,(118.75 ±12.946)d,(123.40 ±24.186)d,(t =13.526 8, t =30.042 8, t =31.240); only 2 cases of postoperative complications, less than 8 cases of the control group(χ~2= 4.41, P<0.05). Conclusion Elderly patients with intertrochanteric fractures undergoing internal fixation with proximal femoral anti-rotation intramedullary nailing can significantly improve hip function and quality of life, shorten treatment and recovery time, reduce complications, and improve treatment.
引文
[1]董佩龙,唐晓波,王健,等.股骨近端防旋髓内钉与骨水泥柄人工股骨头置换治疗老年股骨粗隆间骨折的疗效分析[J]中华关节外科杂志:电子版,2016,10(1):37-42.
[2]黄永栋,赵辉,张虓.PFNA与解剖型锁定钢板内固定治疗老年股骨粗隆间骨折的疗效比较[J].中国骨与关节损伤杂志,2015,30(4):402-404.
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[7]尚红涛.比较股骨近端防旋髓内钉系统与股骨近端解剖型锁定钢板治疗不稳定型股骨粗隆间骨折的效果[J].中国现代医学杂志,2015,25(6):61-65.
[8]张长青,张春啸,张文治,等.PFNA与PFN内固定治疗老年股骨粗隆间骨折的临床疗效评价[J].生物骨科材料与临床研究,2014,11(5):51-54.
[9]魏杰,秦德安,郭秀生,等.防旋型股骨近端髓内钉治疗股骨粗隆间骨折及大粗隆外侧壁不完整型的疗效分析[J]中国骨伤,2015,28(6):572-575.
[10]彭丹,陈振中,曾凡军.两种手术方式治疗外侧壁危险型股骨粗隆间骨折的效果及安全性分析[J].当代医学,201824(6):75-77.
[11]闫丹舟.PFNA与PFN内固定治疗老年股骨粗隆间骨折手术指标、血液相关指标及髋关节Harris评分的对比观察[J].临床和实验医学杂志,2016,15(21):2105-2107.
[12]胡文雄,蒋家正,陈庆雄,等.近端髓内钉固定与滑动髋螺钉髓外固定治疗股骨粗隆间骨折效果比较[J].海南医学2015,26(5):717-719.
[2]黄永栋,赵辉,张虓.PFNA与解剖型锁定钢板内固定治疗老年股骨粗隆间骨折的疗效比较[J].中国骨与关节损伤杂志,2015,30(4):402-404.
[3]苏世先,刘前前,刘真.半髋关节置换与防旋型股骨近端髓内钉治疗高龄不稳定型股骨粗隆间骨折的效果比较[J]实用临床医药杂志,2016,20(3):118-120.
[4]郭涛,张亚奎,张星火,等.股骨近端防旋髓内钉与股骨近端解剖型锁定钢板治疗股骨粗隆间骨折的生物力学研究[J]河北医学,2016,22(1):10-13.
[5]胡文雄,蒋家正,韩宏德,等.股骨近端防旋髓内钉和解剖型锁定钢板治疗不稳定型股骨粗隆间骨折的临床疗效比较[J].中国老年学杂志,2016,36(4):903-904.
[6]连俊锋,邓志荣,杨乐.老年股骨粗隆间骨折PFNA和PFN内固定疗效比较[J].中国骨科临床与基础研究杂志,2016,8(5):298-303.
[7]尚红涛.比较股骨近端防旋髓内钉系统与股骨近端解剖型锁定钢板治疗不稳定型股骨粗隆间骨折的效果[J].中国现代医学杂志,2015,25(6):61-65.
[8]张长青,张春啸,张文治,等.PFNA与PFN内固定治疗老年股骨粗隆间骨折的临床疗效评价[J].生物骨科材料与临床研究,2014,11(5):51-54.
[9]魏杰,秦德安,郭秀生,等.防旋型股骨近端髓内钉治疗股骨粗隆间骨折及大粗隆外侧壁不完整型的疗效分析[J]中国骨伤,2015,28(6):572-575.
[10]彭丹,陈振中,曾凡军.两种手术方式治疗外侧壁危险型股骨粗隆间骨折的效果及安全性分析[J].当代医学,201824(6):75-77.
[11]闫丹舟.PFNA与PFN内固定治疗老年股骨粗隆间骨折手术指标、血液相关指标及髋关节Harris评分的对比观察[J].临床和实验医学杂志,2016,15(21):2105-2107.
[12]胡文雄,蒋家正,陈庆雄,等.近端髓内钉固定与滑动髋螺钉髓外固定治疗股骨粗隆间骨折效果比较[J].海南医学2015,26(5):717-719.