股骨近端防旋髓内钉固定治疗股骨转子间骨折34例疗效观察  

Effects of proximal femoral intramedullary nail antirotation fixation on intertrochanteric fracture of the femur in 34 patients

作　　者：罗庆锋 胡文洁[1] 胡奇哲[1] 胡国锋[1] Luo Qingfeng;Hu Wenjie;Hu Qizhe;Hu Guofeng(Department of Orthopedics,Cixi People's Hospital,Cixi 315300,Zhejiang Province,China)

机构地区：[1]慈溪市人民医院骨科,慈溪315300

出　　处：《中国基层医药》2022年第2期240-244,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省宁波市科技计划项目(2019C50060)。

摘　　要：目的探讨股骨近端防旋髓内钉固定治疗股骨转子间骨折的临床疗效及其对患者Harris评分的影响。方法选取慈溪市人民医院2018年4月至2019年10月收治的股骨转子间骨折患者68例,采用随机数字表法分为对照组、观察组各34例,对照组采用动力髋螺钉内固定,观察组采用股骨近端防旋髓内钉内固定,比较两组临床效果、Harris评分、手术指标和并发症发生情况。结果观察组有效率为94.12%(32/34),高于对照组的76.47%(26/34),差异有统计学意义(χ^(2)=5.81,P<0.05);观察组Harris评分优良率为91.18%(31/34),高于对照组的73.53%(25/34),差异有统计学意义(χ^(2)=6.05,P<0.05);观察组手术时间、手术出血量、切口长度、骨折愈合时间分别为(51.66±10.52)min、(120.26±12.29)mL、(8.09±2.62)cm、(9.86±2.67)周,对照组分别为(78.32±12.23)min、(238.45±17.85)mL、(12.95±3.29)cm、(13.65±3.46)周,两组差异均有统计学意义(t=14.55、14.03、14.85、14.60,均P<0.05);观察组并发症发生率为5.88%(2/34),低于对照组的23.53%(8/34),差异有统计学意义(χ^(2)=6.51,P<0.05)。结论股骨近端防旋髓内钉固定治疗股骨转子间骨折效果显著优于动力髋螺钉内固定,能改善Harris评分,降低并发症发生率,有创新性。Objective To investigate the efficacy of proximal femoral intramedullary nail antirotation fixation in the treatment of intertrochanteric fracture of the femur and its effects on Harris hip scores.Methods Sixty-eight patients with intertrochanteric fracture of the femur who received treatment in Cixi People's Hospital from April 2018 to October 2019 were included in this study.They were randomly assigned to receive dynamic hip screw fixation(control group,n=34)or proximal femoral intramedullary nail antirotation fixation(observation group,n=34).Clinical efficacy,Harris score,surgical indicators,and the incidence of complications were compared between the two groups.Results The response rate was significantly higher in the observation group than in the control group[94.12%(32/34)vs.76.47%(26/34),χ^(2)=5.81,P<0.05].The excellent and good rate of hip function as evaluated by Harris hip scores was significantly higher in the observation group than in the control group[91.18%(31/34)vs.73.53%(25/34),χ^(2)=6.05,P<0.05].The operative time,blood loss,incision length,and fracture healing time in the observation group were(51.66±10.52)minutes,(120.26±12.29)mL,(8.09±2.62)cm,and(9.86±2.67)weeks respectively,and those in the control group were(78.32±12.23)minutes,(238.45±17.85)mL,(12.95±3.29)cm,and(13.65±3.46)weeks,respectively.There were significant differences in these indices between the two groups(t=14.55,14.03,14.85,14.60,all P<0.05).The incidence of complications was significantly lower in the observation group than in the control group[5.88%(2/34)vs.23.53%(8/34),χ^(2)=6.51,P<0.05].Conclusion Proximal femoral intramedullary nail antirotation fixation is superior to dynamic hip screw fixation in the treatment of intertrochanteric fracture of the femur.The former increases Harris hip score,decreases the incidence of complications,and is of great clinical innovation.

关 键 词：股骨骨折 骨折固定术 髓内 骨钉 治疗结果 手术时间 失血 手术 骨折愈合 手术后并发症 

分 类 号：R687.3[医药卫生—骨科学]