股骨近端防旋髓内钉联合抗骨质疏松药物治疗不稳定型老年股骨转子间骨折的临床观察  

A combination therapy of proximal femoral nail antirotation and anti-osteoporotic drugs for the treatment of unstable femoral intertrochanteric fractures in the aged

作　　者：龚江浩[1] 

机构地区：[1]温州医科大学附属义乌医院,浙江义乌322000

出　　处：《中医正骨》2015年第4期29-32,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)联合抗骨质疏松药物治疗老年不稳定型股骨转子间骨折的临床疗效。方法:将纳入研究的140例股骨转子间骨折患者随机分为联合治疗组和PFNA组。联合治疗组采用PFNA内固定术联合口服阿法骨化醇软胶囊、强骨胶囊及维生素D治疗,PFNA组单纯采用PFNA内固定治疗。观察住院时间、骨痂出现时间、骨折愈合时间及术后6个月时的Harris髋关节评分和骨密度。结果:2组患者住院时间及术后6个月Harris评分比较,组间差异均无统计学意义[(15.55±5.13)d,(16.04±5.44)d,t=0.805,P=0.611;(86.23±6.55)分,(85.14±6.06)分,t=1.006,P=0.239];与PFNA组相比,联合治疗组骨痂出现早,骨折愈合快,术后6个月时Ward三角、股骨颈及股骨大转子的骨密度更高[(29.38±4.67)d,(37.55±5.32)d,t=6.126,P=0.009;(3.11±1.14)月,(3.56±1.27)月,t=5.007,P=0.013;(0.877±0.024)g·cm-2,(0.648±0.012)g·cm-2,t=9.552,P=0.001;(1.011±0.064)g·cm-2,(0.802±0.018)g·cm-2,t=11.227,P=0.000;(0.882±0.035)g·cm-2,(0.686±0.023)g·cm-2,t=8.217,P=0.002]。结论:在PFNA内固定的基础上联合应用抗骨质疏松药物,可提高老年不稳定型股骨转子间骨折患者的骨密度,加快骨折愈合。Objective：To observe the clinical curative effects of proximal femoral nail antirotation（PFNA）combined with anti-osteopo-rotic drugs in the treatment of unstable femoral intertrochanteric fractures in the aged.Methods：One hundred and forty patients with femoral intertrochanteric fractures enrolled in the study were randomly divided into combination treatment group and PFNA group.The patients in combination treatment group were treated with PFNA internal fixation combined with oral application of alfacalcidol soft capsules,Qianggu （强骨）capsules and Vitamin D（Vit D）;while the others in PFNA group were treated with the monotherapy of PFNA internal fixation.The hospital stay,bony callus and fracture healing time were observed.Harris hip scores and bone density were evaluate at six months after sur-gery.Results：There was no statistical difference in hospital stay and Harris scores at six months after surgery between the two groups （15.55 ＋/-5.13 vs 16.04 ＋/-5.44 days,t =0.805,P =0.611;86.23 ＋/-6.55 vs 85.14 ＋/-6.06 points,t =1.006,P =0.239）.Com-pared with PFNA group,combination treatment group has shorter bony callus appearing time,shorter fracture healing time and higher bone density of Ward＆#39;s triangle,femoral neck and greater trochanter of femur at six months after surgery（29.38 ＋/-4.67 vs 37.55 ＋/-5.32 days,t =6.126,P =0.009;3.11 ＋/-1.14 vs 3.56 ＋/-1.27 months,t =5.007,P =0.013;0.877 ＋/-0.024 vs 0.648 ＋/-0.012 g/cm（2）, t =9.552,P =0.001;1.011 ＋/-0.064 vs 0.802 ＋/-0.018 g/cm（2）,t =11.227,P =0.000;0.882 ＋/-0.035 vs 0.686 ＋/-0.023 g/cm （2）,t =8.217,P =0.002）.Conclusion：Combination of anti-osteoporosis drugs with PFNA internal fixation can improve the bone density of aged patients with unstable femoral intertrochanteric fractures and accelerate fracture healing.

关 键 词：髋骨折 转子间骨折 抗骨质疏松药 骨质疏松 老年人 股骨近端防旋髓内钉 骨密度 骨痂 治疗 临床研究性 

分 类 号：R687.3[医药卫生—骨科学]