股骨近端交锁髓内钉-抗螺旋刀片治疗老年性股骨粗隆间粉碎性骨折的效果观察  

Effect observation of proximal femoral interlocking intramedullary nail antirotation in the treatment of senile patients with femoral intertrochanteric comminuted fracture

作　　者：张云 何玉涛 ZHANG Yun;HE Yutao(Department of Orthopedics,Red Cross Hospital in Hengshan District of Yulin City,Yulin,Shaanxi,719100)

机构地区：[1]陕西省榆林市横山区红十字医院骨科,陕西榆林719100

出　　处：《实用临床医药杂志》2020年第3期111-114,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨股骨近端交锁髓内钉-抗螺旋刀片(PFNA)内固定术治疗老年性股骨粗隆间粉碎性骨折的效果。方法选取90例老年性股骨粗隆间粉碎性骨折患者作为研究对象,按不同术式分为2组,将采取动力髋螺钉内固定术治疗的45例患者纳入对照组,将采取PFNA内固定术治疗的45例患者纳入研究组,比较2组患者术后近期、远期髋关节功能恢复程度和术后下地负重时间、术中出血量、并发症发生率。结果研究组患者术后3个月、术后1年的髋关节功能恢复优良率分别为71.11%、97.78%,显著高于对照组的48.89%、82.22%(P<0.05);研究组患者术后下地负重时间早于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);研究组围术期并发症发生率为4.44%,显著低于对照组20.00%(P<0.05)。结论老年性股骨粗隆间粉碎性骨折患者适宜采用PFNA内固定术治疗,可减少术后并发症,促使患者早期下地活动,且微创优势明显,对患者远期髋关节功能的恢复有促进作用。Objective To investigate the effect of proximal femoral interlocking intramedullary nail antirotation(PFNA)in the treatment of senile patients with intertrochanteric comminuted fracture of femur.Methods Ninety elderly patients with comminuted intertrochanteric fracture of femur were selected and divided into two groups according to surgical methods.The control group(n=45)was treated with dynamic hip screw internal fixation,and the study group was treated with PFNA(n=45).The short-term and long-term recovery of hip function,the time of weight-bearing after operation,the amount of bleeding during operation and the incidence of complications were compared between the two groups.Results The excellent and good rates of hip function recovery in the study group was 71.11%and 97.78%at 3 months and 1 year after operation,which were significantly higher than 48.89%and 82.22%in the control group(P<0.05).The weight-bearing time in the study group was significantly shorter than that in the control group,and the amount of bleeding in the operation was significantly less than that in the control group(P<0.05).The incidence rate of perioperative complications in the study group was 4.44%,which was significantly lower than 20.00%in the control group(P<0.05).Conclusion For elderly patients with intertrochanteric comminuted fracture of femur,PFNA can reduce the complications after operation,precipitate the early bed-off activity and promote the long-term recovery of hip function with minimally invasive.

关 键 词：股骨近端交锁髓内钉-抗螺旋刀片内固定术 动力髋螺钉内固定术 老年人 股骨粗隆间粉碎性骨折 

分 类 号：R683.42[医药卫生—骨科学]