PFNA治疗高龄骨质疏松股骨粗隆间骨折中近端扩髓与不扩髓的效果分析  

Analysis of the effect of PFNA with or without reaming on senile osteoporotic femoral intertrochanteric fractures

作　　者：王彦 刘锦波[1] 吕正祥[2] WANG Yan;LIU Jin-bo;LYU Zheng-xiang(Department of Orthopedics,Third Affiliated Hospital of Soochow University,Changzhou 213000,China)

机构地区：[1]苏州大学附属第三医院骨科,213000 [2]常州市中医医院骨伤科,213000

出　　处：《中国实用医药》2021年第23期34-36,共3页China Practical Medicine

摘　　要：目的观察高龄骨质疏松股骨粗隆间骨折患者采用防旋股骨近端髓内钉(PFNA)内固定时,近端粗隆部是否使用近端限定扩髓器扩髓对手术的影响。方法80例行PFNA内固定手术的老年股骨粗隆间骨折患者,随机分为A组与B组,各40例。A组手术中股骨粗隆部扩髓,B组手术中股骨粗隆部不扩髓。比较两组术中指标及术后指标。结果B组手术时间(51.62±8.43)min短于A组的(60.37±12.52)min,术中出血量(53.37±10.58)ml、股骨粗隆松质骨丢失量0 ml、C臂机透视次数(13.27±1.81)次均少于A组的(65.75±18.55)ml、(0.76±0.15)ml、(17.10±2.68)次,差异有统计学意义(P<0.05)。两组术后骨折愈合时间、Harris评分比较差异无统计学意义(P>0.05)。结论PFNA治疗老年股骨粗隆间骨折中不近端扩髓可有效减少手术时间、粗隆部松质骨丢失量及术中C臂机透视次数。Objective To observe the effect of proximal femoral nail anti-rotation(PFNA)internal fixation with or without reaming on senile osteoporotic femoral intertrochanteric fractures.Methods A total of 80 senile patients osteoporotic femoral intertrochanteric fractures undergoing PFNA internal fixation were randomly divided into group A and group B,with 40 cases in each group.Group A received reaming of femoral trochanter during operation,and group B received non-reaming of femoral trochanter during operation.The intraoperative indicators and postoperative indicators were compared between the two groups.Results The operation time(51.62±8.43)min of group B was shorter than(60.37±12.52)min of group A,and the intraoperative blood loss(53.37±10.58)ml and femoral tuberosity cancellous bone loss 0 ml and number of C-arm fluoroscopy(13.27±1.81)times were less than(65.75±18.55)ml,(0.76±0.15)ml and(17.10±2.68)times of group A,and the difference was statistically significant(P<0.05).There was no statistically significant difference in fracture healing time and Harris score between the two groups(P>0.05).Conclusion PFNA can effectively reduce the operative time,femoral tuberosity cancellous bone loss and the number of C-arm fluoroscopy in the treatment of senile intertrochanteric fractures.

关 键 词：股骨近端防旋髓内钉 近端扩髓 股骨粗隆间骨折 

分 类 号：R687.3[医药卫生—骨科学]