螺旋刀片型股骨近端防旋髓内钉内固定治疗股骨转子间骨折患者的临床效果  

Clinical Effect of Anti-Rotation Intramedullary Nail Fixation on Femoral Intertrochanteric Fracture with Spiral Blade

作　　者：苟威 崔西湖 GOU Wei;CUI Xihu(Department of Orthopaedics,Baoji Sixth People's Hospital,Baoji Shaanxi 721006)

机构地区：[1]宝鸡市第六人民医院骨科,陕西宝鸡721006 [2]宝鸡市第二人民医院骨科,陕西宝鸡721000

出　　处：《医学临床研究》2024年第4期519-521,525,共4页Journal of Clinical Research

摘　　要：【目的】探讨螺旋刀片型股骨近端防旋髓内钉(PFNA)内固定治疗股骨转子间骨折(FIF)患者的临床效果。【方法】回顾性分析2017年6月至2022年5月宝鸡市第六人民医院收治的108例FIF患者的临床资料,依据治疗方式不同分为PFNA组(采用PFNA内固定治疗,n=57)和动力髋螺钉(DHS)组(采用DHS内固定治疗,n=51)。比较两组手术指标、髋关节功能、影像学检查指标(股骨颈干角、股骨前倾角)、下肢功能评分、生活能力评分及并发症发生率。【结果】PFNA组手术时间、术中出血量少于DHS组(均P<0.05);两组首次负重时间、骨折愈合时间比较,差异无统计学意义(均P>0.05)。PFNA组髋关节Harris评分优良率高于DHS组(P<0.05)。两组患者术后6个月股骨颈干角、股骨前倾角比较,差异无统计学意义(P>0.05)。两组患者术后6个月下肢功能量表(LEFS)评分、Barthel指数评分均高于术前(均P<0.05);但两组患者术后6个月LEFS评分、Barthel指数评分比较,差异无统计学意义(均P>0.05)。两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。【结论】螺旋刀片型PFNA内固定治疗FIF效果较好,可提高患者生活质量,且安全性好,值得临床推广应用。【Objective】To investigate the clinical effect of proximal femoral anti-rotation intramedullary nail(PFNA)with spiral blade in the treatment of femoral intertrochanteric fracture(FIF).【Methods】The clinical data of 108 patients with FIF admitted to the Baoji Sixth People's Hospital,Shaanxi Province from June 2017 to May 2022 were retrospectively analyzed.According to different treatment methods,they were divided into PFNA group(PFNA internal fixation,n=57)and dynamic hip screw(DHS)group(DHS internal fixation,n=51).The surgical indexes,hip function,imaging indexes(femoral neck trunk Angle,femoral anterior inclination Angle),lower extremity function,life ability score and complication rate were compared between the two groups.【Results】The operative time and blood loss in the PFNA group were less than those in the DHS group(all P<0.05).There was no significant difference in the first weight-bearing time and fracture healing time between the two groups(all P>0.05).The good and excellent rate of hip joint Harris score in PFNA group was higher than that in DHS group(P<0.05).There was no significant difference in femoral neck trunk Angle and femoral anterior inclination Angle between the two groups 6 months after operation(P>0.05).The lower limb Function Scale(LEFS)score and Barthel index score of both groups at 6 months after surgery were higher than those before surgery(both P<0.05).There was no significant difference in LEFS score and Barthel index score between the two groups 6 months after surgery(P>0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).【Conclusion】Spiral blade PFNA internal fixation is effective in the treatment of FIF,which can improve the quality of life of patients.It has good safety,which is worthy of clinical application.

关 键 词：股骨颈骨折/外科学 骨折固定术 髓内 骨钉 治疗结果 

分 类 号：R687.32[医药卫生—骨科学]