股骨近端防旋髓内钉与解剖锁定接骨板治疗高龄股骨粗隆间骨折效果观察  

Effect of proximal femoral nail anti-rotation and locking proximal humeral plate on femoral intertrochanteric fracture in elderly patients

作　　者：宋国梁[1] Song Guoliang(Department of Orthopedics, the People＇ s Hospital of Pingyu , Pingyu 463400, Chin)

机构地区：[1]河南省平舆县人民医院骨科,463400

出　　处：《中国实用医刊》2018年第1期77-80,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较股骨近端防旋髓内钉与解剖锁定接骨板治疗高龄股骨粗隆间骨折的临床效果。方法选取高龄股骨粗隆间骨折患者94例，按照随机数字表法分为对照组和观察组，每组47例。对照组行解剖锁定接骨板治疗，观察组行股骨近端防旋髓内钉治疗。比较两组患者的住院时间、出血量、手术时间、骨折愈合时间、髋关节功能、日常生活能力及并发症发生率。结果观察组手术时间[（77．62±10．17）min]和术中出血量[（114．82±23．60）ml]明显少于对照组[（108．84±15．63）min、（225．76±73．71）ml]，差异有统计学意义（P〈0．05）；治疗后，两组Harris评分均较治疗前显著提升，且观察组评分[（79．72±8．08）分]高于对照组[（69．63±5．11）分]，差异有统计学意义（P〈0．05）；治疗后，两组日常生活能力量表（ADL）评分均显著降低，且观察组[（24．83±6．07）分]低于对照组[（31．77±6．16）分]，差异有统计学意义（P〈0．05）。观察组并发症发生率（2．13％）低于对照组（17．02％），差异有统计学意义（P〈0．05）。结论肱骨近端防旋髓内钉相较于解剖锁定接骨板在治疗高龄股骨粗隆间骨折中具有明显的优势，其可有效缩短手术时间及出血量，减少患者对手术的不耐受性，促进髋关节功能恢复，减少并发症发生。Objective To compare the clinical effects of proximal femoral nail anti-rotation （PF- NA） and locking proximal humeral plate （LPHP） on femoral intertroehanterie fracture in elderly patients. Methods Ninety-four elderly patients with femoral intertrochanteric fracture were divided into control group and observation group by random number table method, with 47 cases in each group. Patients in control group were treated by LPHP, while patients in observation group were treated by PFNA. The hospital stays, bleeding volume, operation time, fracture healing time, hip joint function, activity of daily living （ADL）, the incidence of complications were compared between the two groups. Results The operation time and intraoperative bleeding volume in observation group [ （77. 62± 10. 17）min, （114. 82 ± 23. 60） ml ] were less than those in control group [ （ 108.84 ± 15.63 ） rain, （ 225.76 ± 73.71）ml] ,P 〈 0.05; after treatment, the Harris scores of two groups increased compared with those before treatment, and observation group （79.72 ± 8.08） was higher than control group （69.63 ± 5.11 ）, P 〈 0. 05 ; after treatment, the ADL scores of two groups decreased, and observation group （24. 83 ± 6.07） was lower than control group （31.77 ± 6. 16） , P 〈 0. 05. The incidence of complications in observation group （ 2. 13%） was lower than that in control group （ 17.02%）, P 〈 0.05. Conclusions The efficacy of PFNA on femoral intertrochanteric fracture in elderly patients is better than that of LPHP, it can shorten operation time and bleeding volume, reduce intolerance of operation in patients, promote recovery of hip joint function and decrease complications.

关 键 词：股骨近端防旋髓内钉 解剖锁定接骨板 股骨粗隆间骨折 

分 类 号：R687.3[医药卫生—骨科学]