高龄外侧壁危险型股骨粗隆间骨折合并高血压患者行国产InterTan髓内钉治疗的效果、功能恢复与远期预后分析  

Functional recovery and long term prognosis of patients with external wall risk intertrochanteric fracture of femur combined with hypertension treated with domestic InterTan intramedullary nail

作　　者：汪俊协 郑宏磊 Wang Junxie;Zheng Honglei(Department of Second Orthopedics,the People's Hospital of Shexian,Huangshan 245200,China;Department of Orthopedics,Tongling Municipal Hospital,Tongling 244000,China)

机构地区：[1]安徽省歙县人民医院骨二科,黄山245200 [2]铜陵市立医院骨科,铜陵244000

出　　处：《中国医师进修杂志》2024年第8期727-731,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨高龄外侧壁危险型股骨粗隆间骨折合并高血压患者行国产InterTan髓内钉的治疗效果、功能恢复与远期预后。方法回顾性分析2017年1月至2022年6月安徽省歙县人民医院收治的59例高龄外侧壁危险型股骨粗隆间骨折合并高血压患者的临床资料,依据不同的内固定方式分为股骨近端防旋髓内钉(PFNA)组(28例)和国产InterTan髓内钉组(31例),比较两组围手术期资料,包括住院及手术时间、负重时间、切口总长度、术中失血量、透视次数及骨折愈合时间,比较两组术后不同时间点患者的疼痛情况和髋关节Harris评分,并记录术后局部及全身并发症发生情况。结果国产InterTan髓内钉组透视次数及术中失血量高于PFNA组[(24.36±2.62)次比(19.57±2.94)次、(183.09±20.55)ml比(171.25±22.47)ml],差异有统计学意义(P<0.05),但国产InterTan髓内钉组手术时间、住院时间、负重及骨折愈合时间均短于PFNA组[(72.23±16.47)min比(91.43±12.65)min、(13.97±4.52)d比(16.43±4.31)d、(4.31±0.63)d比(5.38±0.72)d、(11.96±2.51)周比(13.35±2.75)周],差异有统计学意义(P<0.05)。术后1个月国产InterTan髓内钉组疼痛视觉模拟量表(VAS)评分低于PFNA组,髋关节Harris评分高于PFNA组[(4.58±1.54)分比(5.56±1.73)分、(64.63±8.36)分比(58.29±7.47)分],差异有统计学意义(P<0.05)。两组局部并发症和全身并发症发生率比较差异无统计学意义(P>0.05)。结论国产InterTan髓内钉和PFNA对高龄外侧壁危险型股骨粗隆间骨折合并高血压患者均具有较好的治疗效果,国产InterTan髓内钉治疗的抗旋转作用及稳定性更佳,但对于身体条件差且存在诸多合并症的患者而言,PFNA治疗能有效减少术中创伤。Objective:To investigate the therapeutic effect,functional recovery and long-term prognosis of domestic InterTan intramedullary nail in elderly patients with external wall risk intertrochanteric fracture of femur complicated with hypertension.Methods:The clinical data of 59 elderly patients with lateral wall dangerous intertrochanteric fracture and hypertension admitted to the People′s Hospital of Shexian from January 2017 to June 2022 were retrospectively analyzed.According to different internal fixation methods,the patients were divided into the proximal femoral antispiral intramedullary nail(PFNA)group(28 cases)and the domestic InterTan intramedullary nail group(31 cases).Perioperative data,postoperative pain and hip Harris score were compared between the two groups,and the local and systemic complications were recorded.Results:The fluoroscopy times and intraoperative blood loss in the domestic InterTan intramedullary nail group were higher than those in the PFNA group:(24.36±2.62)times vs.(19.57±2.94)times,(183.09±20.55)ml vs.(171.25±22.47)ml,there were statistical differences(P<0.05).However,the operation time,hospitalization time,weight bearing and fracture healing time in the domestic InterTan intramedullary nail group were shorter than those in the PFNA group:(72.23±16.47)min vs.(91.43±12.65)min,(13.97±4.52)d vs.(16.43±4.31)d,(4.31±0.63)d vs.(5.38±0.72)d,(11.96±2.51)weeks vs.(13.35±2.75)weeks,there were statistical differences(P<0.05).One month after operation,the visual analogue scale(VAS)score in the domestic InterTan intramedullary nail group was lower than that in the PFNA group,and the Harris score was higher than that in the PFNA group:(4.58±1.54)scores vs.(5.56±1.73)scores,(64.63±8.36)scores vs.(58.29±7.47)scores,there were statistical differences(P<0.05).There were no significant differences in the incidence of local complications and systemic complications between the two groups(P>0.05).Conclusions:Domestic InterTan intramedullary nailing and PFNA have good therapeutic effect on

关 键 词：骨折固定术 髓内 股骨粗隆间骨折 InterTan髓内钉 老年人 

分 类 号：R687.3[医药卫生—骨科学] R544.1[医药卫生—外科学]