股骨近端防旋髓内钉治疗不稳定性老年股骨粗隆间骨折的临床分析  

Clinical analysis of the proximal femoral nail in treatment of unstable femoral intertrochanteric fracture with elderly patients

作　　者：赵灏[1] 陈世宏[1] 黄旭平[1] ZHAO Hao;CHEN Shihong;HUANG Xuping(Department of Orthopedics ,Ankang People's Hospital,Shanxi ,Ankang 725000,China)

机构地区：[1]陕西省安康市人民医院骨科,725000

出　　处：《临床外科杂志》2018年第12期962-964,共3页Journal of Clinical Surgery

摘　　要：目的探讨股骨近端防旋髓内钉(PFNA)治疗不稳定性老年股骨粗隆间骨折的临床价值。方法老年股骨粗隆间骨折病人100例,根据治疗方法的不同分为对照组与观察组,其中对照组51例,行股骨近端锁定加压钢板(LCP)治疗;观察组49例,行PFNA治疗。比较两组病人术后一般情况、髋关节功能、并发症发生情况、生活质量评分。结果观察组病人手术时间(48. 59±5. 54)分钟、术中出血量(96. 58±3. 55) ml、术后下地时间(6. 54±1. 55)天、住院时间(7. 26±1. 22)天、骨折愈合时间(11. 23±2. 44)周;对照组分别为(78. 59±5. 56)分钟,(117. 89±3. 58) ml,(10. 59±1. 54)天,(15. 59±1. 24)天和(13. 59±2. 47)周,两组比较差异有统计学意义(P <0. 05)。观察组病人优良占57. 14%,较好占30. 61%,尚可占10. 20%,差占2. 04%,对照组分别为39. 22%、27. 45%、23. 51%和9. 80%,两组比较差异有统计学意义(P <0. 05)。两组髋关节功能和并发症发生率比较,差异有统计学意义(P <0. 05)。观察组病人各项评分高于对照组(P <0. 05)。结论 PFNA治疗不稳定性老年股骨粗隆间骨折,可缩短手术时间,减少术中出血量,改善髋关节功能。Objective To investigate the clinical analysis of the proximal femoral nail in treatment of unstable femoral intertrochanteric fracture with elderly patients. Methods The clinical data of100 elderly patients with femoral intertrochanteric fracture were analyzed retrospectively. Patients were divided into two groups according to the different treatment methods. 51 patients in the control group received the locking compression plate( LCP),and 49 patients in the observation group received the PFNA.Then the postoperative general conditions,hip function,complications,and quality of life scores were compared between the two groups. Results The operative time,intraoperative blood loss,first walking time,hospital stay,and fracture healing time were significantly shorter in the observation group [( 48. 59 ±5. 54) min,( 96. 58 ± 3. 55) ml,( 6. 54 ± 1. 55) d,( 7. 26 ± 01. 22) d,( 11. 23 ± 2. 44) w]than in the control group[( 78. 59 ± 5. 56) min,( 117. 89 ± 3. 58) ml,( 10. 59 ± 1. 54) d,( 15. 59 ± 1. 24) d,( 13. 59 ±2. 47) w]( P < 0. 05). The observation group had higher rate of the excellent( 57. 14%) and good( 30. 61%) as well as lower rate of the fair( 10. 20%) and poor( 2. 04%) than those of the control group( 39. 22%,27. 45%,23. 51%,9. 80%,respectively)( P < 0. 05). The hip function between the two groups had significant difference( P < 0. 05);The incidence of complications in the observation group( 2. 04%) was significantly lower than that in the control group( P < 0. 05). The scores of patients in the observation group were higher than those in the control group( P < 0. 05). Conclusion The application of the PFNA can significantly shorten the operation time,intraoperative blood loss,improve hip function and postoperative patient quality of life for elderly patients with femoral intertrochanteric fracture.

关 键 词：股骨近端防旋髓内钉 不稳定性 股骨粗隆间骨折 髋关节功能 

分 类 号：R687.3[医药卫生—骨科学]