C臂透视下闭合复位股骨近端抗旋髓内钉微创内固定治疗老年股骨粗隆间骨折的疗效观察  

Curative effect observation on minimally invasive internal fixation with proximal femoral nail anti-rotation in closed reduction through C-arm X-ray machine in the treatment of elderly patients with femoral inter-trochanteric fractures

作　　者：黄章[1] 任飞[1] 白雄伟[1] 张波[1] 彭毅[1] 张科[1] 胡泊[1] HUANG Zhang;REN Fei;BAI Xiong-wei(Department of Orthopedics, People's Hospital of Hanzhoung, Hanzhoung 723000, China)

机构地区：[1]汉中市人民医院骨科,陕西汉中723000

出　　处：《中国医学装备》2017年第8期76-79,共4页China Medical Equipment

摘　　要：目的:观察C臂透视下闭合复位股骨近端抗旋髓内钉(PFNA)微创内固定治疗老年股骨粗隆间骨折的疗效。方法:选取医院120例老年股骨粗隆间骨折患者,根据不同固定方式将其分为对照组和观察组,每组60例。经C臂透视和闭合复位下,对照组采用股骨近端带锁髓内钉(PFN)内固定治疗;观察组采用经股骨近端抗旋髓内钉PFNA微创内固定治疗。记录两组手术相关参数情况,对比分析其治疗效果。结果:两组手术用时、术中出血量、术后血红蛋白值和术后充分负重时间的比较差异均有统计学意义(t=7.98,t=8.12,t=12.05,t=11.85;P<0.05);两组术后并发症的发生率比较,差异亦有统计学意义(x^2=24.65,P<0.05)。而术前血红蛋白值和末次随访髋关节Harris髋关节评分两组比较,其差异均无统计学意义(t=1.32,t=1.02;P>0.05)。结论:通过C臂透视下闭合复位PFNA股骨近端抗旋髓内钉微创内固定的治疗方式能够改善老年股骨粗隆间骨折患者骨质丢失和医源性血运障碍,手术方便、安全、且可行,并能够减少手术时间和降低术中出血量,显著固定骨折,促进骨折愈合,并且能够降低术后并发症的发生率,临床上值得进一步应用和推广效果良好。Objective:To observe the curative effects on minimally invasive internal fixation with proximal femoral nail anti-rotation in closed reduction through C-arm X-ray machine in the treatment of elderly patients with femoral inter-trochanteric fractures.Methods:120elderly patients with femoral inter-trochanteric fracture were divided into the control group treated with internal fixation of proximal femoral nail(60cases)and the observation group with minimally invasive internal fixation of proximal femoral nail anti-rotation(60cases)as different treatment method.All of these operations were implemented in closed reduction through C-arm X-ray machine.The related surgical parameters were recorded and the clinical effects were compared between the two groups.Results:The differences of the operative time,intraoperative blood-losing,postoperative hemoglobin value,postoperative full weight-bearing time between the two groups were significant(t=7.98,t=8.12,t=12.05,t=11.85;P<0.05)and the incidence rate of postoperative complication between the two groups also was significant(x2=24.65,P<0.05).While the difference of preoperative hemoglobin value and Harris scores at the last follow-up between the two groups were not significant(t=1.32,t=1.02;P>0.05),respectively.Conclusion:Minimally invasive internal fixation with proximal femoral nail anti-rotation in closed reduction through C-arm X-ray machine for the treatment of elderly patients with femoral inter-trochanteric fractures can improve the bone loss and iatrogenic hemodynamic disorders of these patients,which is convenient,safe and practicable.Besides,it also can reduce the operative time and intraoperative bloodlosing,obviously fix the position of fracture,promote the healing of fracture,and increase the incidence rate of postoperative complication.Therefore,it has better curative effect in clinical application.

关 键 词：股骨近端抗旋髓内钉 股骨近端带锁髓内钉 老年股骨粗隆间骨折 微创 

分 类 号：R730.55[医药卫生—肿瘤]