老年膝骨关节炎患者股骨转子间骨折行股骨近端防旋髓内钉内固定的疗效分析  

Clinical effects of anti-rotation intramedullary nail internal fixation in femoral proximal femur in treatment of intertrochanteric fractures of elderly patients with knee osteoarthritis

作　　者：孙建亭[1] 王征 许建多 SUN Jianting;WANG Zheng;XU Jianduo(Langfang Municipal People’s Hospital,Hebei,Langfang 065099,China;不详)

机构地区：[1]河北省廊坊市人民医院,065099 [2]河北省石家庄市人民医院

出　　处：《河北医药》2021年第22期3413-3416,共4页Hebei Medical Journal

摘　　要：目的探讨老年膝骨关节炎性患者股骨转子间骨折行股骨近端防旋髓内钉内固定(PFNA)的临床疗效。方法纳入95例老年股骨转子间骨折采用股骨近端防旋髓内钉内固定患者,根据术前膝关节骨性关节炎X射线K-L分级分为0级组(n=17),Ⅰ级组(n=16),Ⅱ级组(n=18),Ⅲ级组(n=21),Ⅳ组(n=23)。比较5组患者的术后下地时间、术后并发症发生率、住院时间、骨折愈合时间,术后1、3、6个月的髋关节Harris评分及日常生活能力Barthel指数。结果Ⅲ、Ⅳ级组术后下地时间、骨折愈合时间高于0、Ⅰ、Ⅱ级组(P<0.05);Ⅲ、Ⅳ组术后并发症发生率高于0、Ⅰ、Ⅱ级组(P<0.05);Ⅲ、Ⅳ组术后1、3、6个月的Harris及Barthel评分均低于前3组(P<0.05)。结论对于合并膝骨关节炎的患者,股骨近端防旋髓内钉内固定的疗效随着分级的增加而下降。Objective To investigate the clinical effects of anti-rotation intramedullary nail internal fixation(PFNA)in femoral proximal femur in treatment of intertrochanteric fractures of elderly patients with knee osteoarthritis.Methods Ninety-five elderly patients with femoral intertrochanteric fracture who were treated by PFNA in our hospital were enrolled in the study.According to the preoperative X-ray KL classification of knee osteoarthritis,these patients were divided into group 0(n=17),groupⅠ(n=16),groupⅡ(n=18),groupⅢ(n=21),groupⅣ(n=23).The postoperative activity time,the incidence of postoperative complications,hospital stay,bone fracture healing time,Harris score of hip joint and Barthel index of daily living ability at 1m,3m,and 6m after operation were observed and compared among the groups.Results The postoperative activity time and bone fracture healing time in groupⅢand groupⅣwere significantly longer than those in the other three groups(P<0.05),and the incidences of postoperative complications in groupⅢand groupⅣwere significantly higher than those in the other three groups(P<0.05).Moreover the Harris scores and Barthel scores at 1m,3m,and 6m after operation in groupⅢand groupⅣwere significantly lower than those in the other three groups(P<0.05).Conclusion For elderly patients with knee osteoarthritis,the therapeutic effects of PFNA were decreased with the increase of the classification of knee osteoarthritis.

关 键 词：股骨 内固定 股骨转子间骨折 膝骨性关节炎 股骨近端防旋髓内钉 

分 类 号：R684.3[医药卫生—骨科学]