不同内固定术治疗老年股骨转子间骨折的效果研究  

Study on effect of different internal fixation procedures in the treatment of intertrochanteric fractures of the femur in the elderly

作　　者：王建伟 WANG Jian-wei(Orthopedics Department,Heze Medical College Affiliated Hospital,Heze 274000,China)

机构地区：[1]菏泽医学专科学校附属医院骨外科,274000

出　　处：《中国实用医药》2023年第13期61-64,共4页China Practical Medicine

摘　　要：目的 分析老年股骨转子间骨折患者应用股骨近端防旋髓内钉(PFNA)与动力髋螺钉(DHS)内固定术治疗的效果。方法 89例老年股骨转子间骨折患者,按照随机数字表法分为对照组(44例)与研究组(45例)。研究组接受PFNA内固定术治疗,对照组接受DHS内固定术治疗。比较两组术中与术后情况、髋关节功能及术后不良事件发生情况。结果 研究组术中操作时间(76.52±8.56)min及骨折愈合时间(13.20±1.56)周均短于对照组的(102.49±7.45)min、(15.65±1.65)周,术中出血量(180.65±22.50)ml少于对照组的(345.45±35.02)ml,住院费用(4.56±0.45)万元高于对照组的(2.39±0.54)万元,差异有统计学意义(P<0.05);两组住院时间比较,差异无统计学意义(P>0.05)。术前,两组Harris评分比较,差异无统计学意义(P>0.05);术后3个月,研究组Harris评分(62.44±4.89)分高于对照组的(55.48±5.00)分,差异有统计学意义(P<0.05)。两组术后不良事件发生率比较,差异无统计学意义(P>0.05)。结论 老年股骨转子间骨折患者采用DHS内固定术治疗的费用较低,但PFNA内固定术更利于髋关节功能恢复,并具有术中操作时间短、出血量少、术后恢复快等优势,临床可以根据患者个体情况合理选择治疗方案。Objective To analyze the effect of droximal femoral nail antirotation(PFNA)and dynamic hip screws(DHS)in the treatment of elderly patients with intertrochanteric fractures of the femur.Methods A total of 89 elderly patients with intertrochanteric fractures of the femur were divided into control group(44 cases)and research group(45 cases)according to the random numerical table.The research group was treated with PFNA internal fixation,and the control group was treated with DHS internal fixation.The intraoperative and postoperative conditions,hip function,and postoperative adverse events were compared between the two groups.Results The operative time of(76.52±8.56)min and fracture healing time of(13.20±1.56)weeks in the research group were shorter than those of(102.49±7.45)min and(15.65±1.65)weeks in the control group;the intraoperative blood loss of(180.65±22.50)ml in the research group was less than that of(345.45±35.02)ml in the control group;the hospitalization cost of(4.56±0.45)ten thousand yuan in the research group was more than that of(2.39±0.54)ten thousand yuan in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in length of hospital stay between the two groups(P>0.05).Before surgery,there was no statistically significant difference in Harris score between the two groups(P>0.05).3 months after surgery,the Harris hip score of(62.44±4.89)points in the research group was higher than that of(55.48±5.00)points in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of postoperative adverse events between the two groups(P>0.05).Conclusion In elderly patients with intertrochanteric fractures of the femur,DHS internal fixation has a lower cost,but PFNA internal fixation is more conducive to hip functional recovery,and has the advantages of short operative time,less blood loss,and quick postoperative recovery.Clinical treatment can be reasonabl

关 键 词：股骨近端防旋髓内钉内固定术 动力髋螺钉内固定术 股骨转子间骨折 老年 

分 类 号：R687.3[医药卫生—骨科学]