股骨近端防旋髓内钉联合钢丝固定小转子治疗老年转子间骨折的效果及对患者下床时间和术后并发症发生率的影响  

Effect of proximal femoral nail antirotation combined with steel wire fixation of small trochanter in the treatment of intertrochanteric fracture in elderly patients and its influence on the get out of bed time and postoperative complication rate

作　　者：储传兵 王铜善 宋体忠 CHU Chuanbing;WANG Tongshan;SONG Tizhong(Department of Orthopaedics,Ganyu District Hospital of Traditional Chinese Medicine,Lianyungang,Jiagnsu,222100,China)

机构地区：[1]连云港市赣榆区中医院骨科,江苏连云港222100

出　　处：《当代医学》2023年第22期80-83,共4页Contemporary Medicine

摘　　要：目的探讨股骨近端防旋髓内钉(PFNA)联合钢丝固定小转子治疗老年转子间骨折患者的疗效及对患者下床时间和术后并发症发生率的影响。方法选取2019年3月至2021年11月本院治疗的40例老年股骨转子间骨折患者作为研究对象,根据随机抽样法分为常规组与研究组,每组20例。常规组采用单纯PFNA内固定治疗,研究组采用PFNA与钢丝固定小转子结合治疗,比较两组并发症发生情况、临床相关指标及胯关节恢复情况。结果研究组并发症发生率(5.00%)低于常规组(35.00%),差异有统计学意义(P<0.05)。研究组手术时间长于常规组,术中出血量多于常规组,Harris髋关节评分高于常规组,下床时间、骨折愈合时间、住院时间、部分负重时间、完全负重时间低于常规组,差异有统计学意义(P<0.05)。研究组髋关节恢复优良率(95.00%)高于常规组(60.00%),差异有统计学意义(P<0.05)。结论采取PFNA与钢丝固定小转子结合治疗老年股骨转子间骨折患者,可减少并发症发生率,促进患者骨折愈合,且髋关节恢复优良率较高,值得临床推广应用。Objective To explore the effect of proximal femoral nail antirotation(PFNA)combined with steel wire fixation of small trochanter in the treatment of intertrochanteric fracture in elderly patients and its influence on the get out of bed time and postoperative complication rate.Methods 40 elderly patients with intertrochanteric fracture of femur treated in our hospital from March 2019 to November 2021 were selected as the research subjects,and they were divided into the routine group and the study group according to random sampling method,with 20 cases in each group.The routine group was treated with PFNA alone,while the study group was treated with PFNA combined with steel wire fixation.After treat-ment,the complications,clinical related indexes and hip joint recovery were compared between the two groups.Results The complication rate in the study group was lower than that in the routine group,and the difference was statistically significant(P<0.05).The operative time in the study group was longer than that in the routine group,the amount of intraoperative blood loss was more than that in the routine group,the Harris hip score was higher than that in the routine group,and the get out of bed time,fracture healing,hospital stay,partial weight bearing time and full weight bear-ing time were lower than those in the routine group,and the differences were statistically significant(P<0.05).The recovery rate of hip joint in the study group was higher than that in the routine group,and the difference was statistically significant(P<0.05).Conclusion The combination of PF-NA and steel wire fixation of trochanter in the treatment of elderly patients with intertrochanteric fracture can improve the incidence of complica-tions,promote fracture healing,and have higher rate of hip recovery,which is worthy of clinical promotion and application.

关 键 词：股骨近端防旋髓内钉 钢丝 小转子 转子间骨折 下床时间 并发症 

分 类 号：R687.3[医药卫生—骨科学]