加长PFNA内固定术对骨质疏松性股骨粗隆间骨折愈合及功能恢复的影响研究  

The Effect of Extended PFNA Internal Fixation on the Healing and Functional Recovery of Osteoporotic Intertrochanteric Fractures of the Femur

作　　者：朱彦华 金思华 沈浩 ZHU Yanhua;JIN Sihua;SHEN Hao(Department of orthopedics,Wujiang district fifth people's hospital,Suzhou city,Suzhou,Jiangsu 215200)

机构地区：[1]苏州市吴江区第五人民医院骨科,江苏苏州215200

出　　处：《中国伤残医学》2024年第8期75-78,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:分析骨质疏松性股骨粗隆间骨折采用加长股骨近端防旋髓内钉(PFNA)内固定术治疗对骨折愈合、功能恢复的影响.方法:选择为2018年1月—2022年6月我院接收的60例骨质疏松性股骨粗隆间骨折患者为研究对象,利用随机数字表法将其分为对照组和观察组,各30例.对照组采取常规Gamma钉内固定术治疗,观察组采取加长PFNA内固定术治疗.对比2组的围术期指标、髋关节功能、生物力学特征、并发症发生率.结果:2组患者手术时间对比,差异无统计学意义(P>0.05);观察组术中出血量少于对照组,切口长度短于对照组,住院时间、骨折愈合时间均短于对照组,组间差异有统计学意义(P<0.05).术后3个月,观察组关节疼痛评分低于对照组,功能、活动评分均高于对照组,组间差异有统计学意义(P<0.05).术后12个月,2组患者荷载800 N的压缩刚度、扭转1.5°的扭转矩、扭转1.5°的扭转刚度均高于术后6个月,且观察组高于对照组,差异有统计学意义(P<0.05);术后12个月,2组患者荷载800 N时的压缩位移均低于术后6个月,且观察组低于对照组,差异有统计学意义(P<0.05).观察组并发症发生率低于对照组,差异有统计学意义(P<0.05).结论:加长PFNA内固定术治疗骨质疏松性股骨粗隆间骨折的效果显著,可缩小手术切口,减少对患者的损伤,加快骨折愈合的进程,另外对髋关节功能也有较好的调节作用,可提升髋关节的生物力学稳定性,降低术后并发症发生率.Objective:Analysis of the impact of extended proximal femoral nail antirotation(PFNA)internal fixation on fracture healing and functional recovery in osteoporotic intertrochanteric fractures of the femur.Methods:60 patients with osteoporotic intertrochanteric fractures of the femur admitted to our hospital from January 2018 to June 2022 were selected as the research subjects,divide them into a control group and an observation group using a random number table method,with 30 cases in each group.The control group was treated with conventional gamma nail internal fixation,while the observation group was treated with extended PFNA internal fixation.Compare perioperative indicators,hip joint function,biomechanical characteristics,and incidence of complications between two groups.Results:There was no significant difference in surgical time between the two groups of patients(P>0.05);The observation group had less intraoperative bleeding than the control group,shorter incision length,shorter hospital stay,and shorter fracture healing time than the control group,and the differences between the two groups were statistically significant(P<0.05).Three months after surgery,the joint pain score in the observation group was lower than that in the control group,while the functional and activity scores were higher than those in the control group,and the differences between the two groups were statistically significant(P<0.05).At 12 months post surgery,the compressive stiffness of 800 N,torsional moment of 1.5°,and torsional stiffness of 1.5°in both groups of patients were higher than those at 6 months post surgery,and the observation group was higher than the control group,and the differences were statistically significant(P<0.05).After 12 months of surgery,the compressive displacement at a load of 800 N in both groups of patients was lower than that at 6 months after surgery,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).The incidence of complications in th

关 键 词：加长股骨近端防旋髓内钉 内固定术 骨质疏松 股骨粗隆间骨折 髋关节功能 并发症 

分 类 号：R687.3[医药卫生—骨科学]