股骨近端防旋髓内钉与动力髋螺钉治疗高龄股骨粗隆间骨折的术后骨愈合时间及并发症情况比较  

Comparison of fracture healing time and complications between proximal femoral anti-rotation intramedullary nail and dynamic hip screw in the treatment of elderly intertrochanteric fracture

作　　者：王大玉 程中午 张本结 WANG Dayu;CHENG Zhongwu;ZHANG Benjie(Department of Orthopedics,Suzhou First People’s Hospital,Anhui Province,Suzhou234000,China)

机构地区：[1]安徽省宿州市第一人民医院骨三科,安徽宿州234000

出　　处：《中国医药导报》2021年第12期107-110,共4页China Medical Herald

基　　金：安徽省卫生科研项目(2017LB0019)。

摘　　要：目的探讨股骨近端防旋髓内钉(PFNA)和动力髋螺钉(DHS)对高龄股骨粗隆间骨折的术后骨愈合时间及并发症情况影响。方法选取2016年10月—2019年10月安徽省宿州市第一人民医院收治的84例高龄股骨粗隆骨折患者,按随机数字表法分为观察组(42例)和对照组(42例)。观察组采用PFNA治疗,对照组采用DHS治疗,比较两组手术相关指标(手术时间、术中出血量、切口长度、骨折愈合时间、下床活动时间、住院时间)。比较两组术前及术后2周的视觉模拟评分(VAS),比较两组术后2周的髋关节功能情况及术后1年内并发症发生情况。结果观察组切口长度、手术时间、骨折愈合时间、下床活动时间、住院时间均短于对照组,术中出血量低于对照组,差异均有统计学意义(均P<0.05)。术后,两组VAS均低于术前,且观察组低于对照组,差异均有统计学意义(均P<0.05)。观察组髋关节Harris评分优良率高于对照组,并发症总发生率低于对照组,差异均有统计学意义(均P<0.05)。结论PFNA治疗高龄股骨粗隆间骨折患者的术后骨折愈合时间短于DHS治疗,并能有效减少并发症发生情况。Objective To investigate the effects of fracture healing time and complications between proximal femoral anti-rotation intramedullary nail(PFNA)and dynamic hip screw(DHS)in the treatment of elderly intertrochanteric fracture.Methods Eighty-four elderly patients with intertrochanteric fracture admitted to Suzhou First People’s Hospital,Anhui Province from October 2016 to October 2019 were selected and they were divided into observation group(42 cases)and control group(42 cases)according to the random number table method.PFNA treatment was used in the observation group,and DHS treatment was used in the control group.Operation-related indicators(operative time,intraoperative blood loss,incision length,fracture healing time,activity time out of bed,and hospitalization time)were compared between the two groups.The visual analogue scale(VAS)before and two weeks after operation,the situation of hip function at two weeks after operation and the incidence of complications at one year after operation were compared between the two groups.Results The incision length,operative time,fracture healing time,activity time out of bed and hospitalization time in the observation group were shorter than those in the control group,and the intraoperative blood loss was lower than that in the control group,with statistical significance(all P<0.05).After operation,VAS in both groups was lower than that before operation,and observation group was lower than control group,the differences were statistically significant(all P<0.05).The excellent and good rate of Harris hip score in the observation group was higher than that in the control group,and the total incidence of complications was lower than that in the control group,with statistical significance(all P<0.05).Conclusion The fracture healing time of elderly patients with intertrochanteric fracture treated by PFNA is shorter than that of DHS treatment,and can effectively reduce the incidence of complications.

关 键 词：股骨近端防旋髓内钉 动力髋螺钉系统 股骨粗隆间骨折 骨折愈合时间 并发症 

分 类 号：R683.4[医药卫生—骨科学]