两种不同内固定术治疗老年股骨粗隆间骨折的效果对比  

Comparison of the effect of two different internal fixation in the treatm ent of senile intertrochanteric fracture of femur

作　　者：胡曙荣 黄俊文[1] 潘月帆 谢健雄 黄安劲 HU Shurong;HUANG Junwen;PAN Yuefan;XIE Jianxiong;HUANG Anjin(Department of Orthopedics,The Second People’s Hospital of Jiangmen,Pengjiang Branch of Jiangmen Central Hospital,Jiangmen 529000)

机构地区：[1]江门市第二人民医院,江门市中心医院蓬江分院骨科,广东江门529000

出　　处：《当代医药论丛》2022年第7期56-60,共5页

基　　金：江门市科技立项:皮瓣覆盖、抗生素骨水泥填充、负压封闭灌注冲洗治疗创伤性骨髓炎并软组织缺损的临床研究。

摘　　要：目的:比较用微创动力髋螺钉内固定术与微创股骨近端防旋髓内钉内固定术对老年股骨粗隆间骨折(ITF)患者进行治疗的效果。方法:选取江门市中心医院蓬江分院收治的126例老年ITF患者作为试验对象。按照手术方式的不同将其分为对照组和研究组。对对照组患者进行微创动力髋螺钉内固定术,对研究组患者进行微创股骨近端防旋髓内钉内固定术,然后比较两组患者的各项临床指标。结果:研究组患者术中的出血量少于对照组患者,其手术的时间、术后下床活动的时间、术后住院的时间和术后骨折端愈合的时间均短于对照组患者,差异有统计学意义(P<0.05)。术后3个月及12个月,研究组患者Harris髋关节功能评分量表(HHS)的评分和髋部骨折功能恢复量表(FRS)的评分均高于对照组患者,差异有统计学意义(P<0.05)。术后3个月,研究组患者欧洲五维健康量表(EQ-5D)中各项指标的评分均高于对照组患者,差异有统计学意义(P<0.05)。结论:与对老年ITF患者进行微创动力髋螺钉内固定术相比,对其进行微创股骨近端防旋髓内钉内固定术的效果更好,能更有效地减少其术中的出血量,缩短其手术的时间和术后恢复的时间,促进其骨折端的愈合及髋关节功能的恢复,提高其生活质量。Objective:To compare the efficacy of minimally invasive dynamic hip screw internal fixation with minimally invasive proximal femoral anti-rotation intramedullary nail internal fixation in the treatment of elderly patients with intertrochanteric fracture(ITF).Methods:126 elderly ITF patients admitted to Pengjiang Branch of Jiangmen Central Hospital were selected as experimental subjects.They were divided into control group and study group according to different surgical methods.Patients in the control group were treated with minima lly invasive dynamic hip screw internal fixation,and patients in the research group were treated with minimally invasive anti-rotation femoral nail internal fixation,and then the clinical indicators of the two groups were compared.Results:The amount of intraoperative blood loss in the study group was less than that in the control group,and the time of operation,the time of postoperative ambulation,the time of postoperative hospitalization and the time of postoperative fracture healing were shorter than those in the control group,with statistical significance(P<0.05).At 3 months and 12 months after surgery,Harris hip function Score scale(HHS)and Hip fracture Function Recovery Scale(FRS)scores of patients in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).Three months after surgery,the scores of all indicators of eQ-5D in the study group were higher than those in the control group,with statistical significance(P<0.05).Conclusions:minimally invasive and the patients with senile ITF dynamic hip screw fixation,compared to the minimally invasive proximal femoral rotation prevention intramedullary nail fixation effect is better,can more effectively reduce the perioperative blood loss,in to shorten the time of the surgery and postoperative recovery time,promote healing of the fracture end,and the recovery of hip function,improve the quality of life.

关 键 词：微创动力髋螺钉内固定术 微创股骨近端防旋髓内钉内固定术 老年 股骨粗隆间骨折 生活质量 

分 类 号：R683.42[医药卫生—骨科学]