不同内固定方式治疗老年股骨粗隆间骨折患者的临床效果及对术后骨代谢的影响  

Clinical effect of different internal fixation methods in the treatment of elderly patients with intertrochanteric fracture and its influence on postoperative bone metabolism

作　　者：浦梦安 PU Meng'an(Wuxi Xishan People's Hospital,Wuxi 214105,China)

机构地区：[1]无锡市锡山人民医院,江苏无锡214105

出　　处：《临床医学研究与实践》2024年第25期62-65,共4页Clinical Research and Practice

摘　　要：目的探索三根钉和股骨近端防旋髓内钉(PFNA)内固定治疗老年股骨粗隆间骨折的临床效果。方法选取2022年1月至2023年1月无锡市锡山人民医院收治的56例股骨粗隆间骨折患者为研究对象,根据内固定方式差异将其分为三根钉组(21例,三根钉内固定)和PFNA组(35例,PFNA内固定)。比较两组的骨代谢情况、疼痛程度、髋关节功能、骨折愈合情况及并发症发生情况。结果术后1、3个月,PFNA组的骨密度、骨钙素水平高于三根钉组(P<0.05);术后1、3、6个月,两组的骨密度、骨钙素水平逐渐升高,且PFNA组升高更为明显(P<0.05)。术后1周、术后1个月,PFNA组的视觉模拟评分法(VAS)评分低于三根钉组(P<0.05);术后1周开始两组的VAS评分均逐渐降低,PFNA组的疼痛缓解更快。术后1、3、6个月及末次随访,PFNA组的Harris评分高于三根钉组(P<0.05)。PFNA组的骨折愈合时间短于三根钉组(P<0.05)。PFNA组的并发症总发生率低于三根钉组,但差异无统计学意义(P=0.22)。结论三根钉或PFNA内固定都能促进老年股骨粗隆间骨折患者成骨代谢、缓解疼痛、恢复关节功能,但PFNA内固定的效果更优。Objective To explore the clinical effect of three-nails and proximal femoral nail anti-rotation(PFNA)internal fixation in the treatment of elderly patients with intertrochanteric fracture.Methods A total of 56 patients with intertrochanteric fracture admitted in Wuxi Xishan People's Hospital from January 2022 to January 2023 were selected as the research objects.According to the difference of internal fixation methods,the patients were divided into three-nails group(21 cases,three-nails internal fixation)and PFNA group(35 cases,PFNA internal fixation).Bone metabolism,pain degree,hip joint function,fracture healing and complications were compared between the two groups.Results At 1 and 3 months after operation,the bone mineral density and osteocalcin level in the PFNA group were higher than those in the three-nails group(P<0.05);at 1,3 and 6 months after operation,the bone mineral density and osteocalcin level of the two groups gradually increased,and the increase in the PFNA group was more obvious(P<0.05).At 1 week and 1 month after operation,the Visual Analogue Scale(VAS)score of the PFNA group was lower than that of the three-nails group(P<0.05);the VAS score of the two groups decreased gradually from 1 week after operation,and the pain relief in the PFNA group was faster.At 1,3,6 months after operation and at the last follow-up,the Harris score of the PFNA group was higher than that of the three-nails group(P<0.05).The fracture healing time of the PFNA group was shorter than that of the three-nails group(P<0.05).The total incidence of complications in the PFNA group was lower than that in the three-nails group,but the difference was not statistically significant(P=0.22).Conclusion Three-nails or PFNA internal fixation can promote bone metabolism,relieve pain and restore joint function in elderly patients with intertrochanteric fractures,but PFNA internal fixation has better effect.

关 键 词：股骨粗隆间骨折 股骨近端防旋髓内钉 骨密度 骨钙素 骨代谢 

分 类 号：R687.3[医药卫生—骨科学]