股骨近端(抗旋转)髓内钉内固定在老年股骨转子间骨折的手术方法和临床疗效观察  

Surgical Method and Clinical Effect of Proximal Femur(Anti Rotation) Intramedullary Nail Fixation in Elderly Patients with Intertrochanteric Fracture

作　　者：钟志[1] 林大鹏 ZHONG Zhi;LIN Dapeng(Meizhou Traditional Chinese Medicine Hospital,Meizhou 514071,China)

机构地区：[1]广东省梅州市中医医院,广东梅州514071

出　　处：《中国医学创新》2018年第2期118-121,共4页Medical Innovation of China

摘　　要：目的:观察股骨近端(抗旋转)髓内钉(PFNA)内固定在老年股骨转子间骨折的手术方法和临床疗效。方法:选择2012年1月-2016年12月在本院进行股骨转子间骨折手术治疗的老年患者100例进行临床研究。所有患者均经X线、CT等影像学检查确诊。使用随机数字表将患者分为观察组和对照组,各50例。对照组患者给予动力髋螺钉(DHS)内固定治疗,观察组患者行PFNA手术,比较两组的疗效和手术相关指标。结果:观察组患者术中出血量、切口长度、手术时间、术后下地时间以及骨折愈合时间均明显少于对照组,差异均有统计学意义(P<0.05);随访12周,使用Harris评分评价髋关节功能,观察组患者优良率为92.00%,略高于对照组的88.00%,但差异无统计学意义(P>0.05);观察组5例患者发生术后并发症,发生率为10.00%,对照组12例发生术后并发症,发生率为12.00%。观察组并发症发生率略低于对照组,差异无统计学意义(P>0.05)。结论:PFNA内固定对于老年股骨转子间骨折具有良好的临床疗效,手术创伤小,患者恢复快,且疗效稳定,术后并发症较少,是老年股骨转子间骨折患者的较好选择。Objective:To observe the surgical method and clinical effect of proximal femur(anti rotation)intramedullary nail(PFNA)fixation in elderly patients with intertrochanteric fracture.Method:The clinical study of 100 elderly patients with intertrochanteric fracture in our hospital from January 2012 to December 2016 was selected.All patients were diagnosed by X-ray,CT and other imaging examinations.The patients were divided into the observation group and the control group,each with a random number table,50 cases in each group.The patients in the control group were treated with dynamic hip screw(DHS)internal fixation,and the patients in the observation group were operated on by PFNA.The results of two groups were compared and the related indexes of the operation were compared.Result:The amount of bleeding,the length of incision,the time of operation,postoperative time and fracture healing time of the fracture of the observation group were significantly less than those of the control group,and the differences were statistically significant(P<0.05).12 weeks of follow-up,the hip joint function of patients was evaluated with Harris score,the excellent rate of the observation group was 92.00%,it was slightly higher than 88.00%of the control group,but there was no difference between two groups(P>0.05).The complication rate of the observation group was 10.00%(5 cases),the control group was 12.00%(6 cases),the observation group was slightly lower than that of the control group,but there was no difference between two groups(P>0.05).Conclusion:PFNA fixation has a good clinical curative effect for elderly patient with intertrochanteric fracture,the surgical trauma is small,recovered quickly,the curative effect is stable,less postoperative complications,is a good choice for elderly patients with intertrochanteric fracture.

关 键 词：股骨近端 髓内钉 内固定 老年 股骨转子间骨折 

分 类 号：R687.3[医药卫生—骨科学]