人工股骨头置换术和股骨近端防旋髓内钉固定术治疗老年人不稳定型股骨粗隆间骨折的效果对比  

Comparison of Effect of Artificial Femoral Head Replacement and Proximal Antirotation Intramedullary Nail Fixation in the Treatment of Unstable Intertrochanteric Femoral Fractures in the Elderly

作　　者：祝建峰 Zhu Jianfeng(Department of Orthopedics,Changshu Haiyu Central Health Center,Changshu 215500,Jiangsu Province,China)

机构地区：[1]常熟市海虞中心卫生院骨科,江苏常熟215500

出　　处：《中外医药研究》2024年第34期39-41,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:比较人工股骨头置换术(FHR)和股骨近端防旋髓内钉(PFNA)固定术治疗老年人不稳定型股骨粗隆间骨折的效果。方法:选取常熟市海虞中心卫生院骨科于2018年1月—2023年6月收治的股骨粗隆间骨折老年患者61例为研究对象,采用随机数字表法分为PFNA组(n=31)与FHR组(n=30)。PFNA组采用PFNA固定术治疗,FHR组采用FHR治疗。比较两组术中及术后指标、术后并发症发生情况、髋关节功能。结果:PFNA组手术时间短于FHR组,术中出血量少于FHR组,术中透视次数多于FHR组(P<0.05)。PFNA组术后引流量少于FHR组,术后首次下床时间晚于FHR组,住院时间长于FHR组(P<0.05)。FHR组术后并发症总发生率低于PFNA组(P=0.041)。术前,两组Harris评分比较,差异无统计学意义(P>0.05);术后1、3、6个月,两组Harris评分升高(P<0.05);术后1、3个月,FHR组Harris评分均高于PFNA组(P<0.05);术后6个月,两组Harris评分比较,差异无统计学意义(P>0.05)。结论:针对老年人不稳定型股骨粗隆间骨折患者,FHR治疗的效果更佳,术中透视次数少,术后恢复快,并发症发生风险低,髋关节功能早期恢复效果更好,但PFNA固定术手术时间短,术中出血量及术后引流量少。Objective:To compare the effect of artificial femoral head replacement(FHR)and proximal antirotation intramedullary nail(PFNA)fixation in the treatment of unstable intertrochanteric femoral fractures in the elderly.Methods:Sixty-one elderly patients with intertrochanteric fracture of femur admitted to the Department of Orthopedics of Changshu Haiyu Central Health Center from January 2018 to June 2023 were selected as the study objects,and were divided into PFNA group(n=31)and FHR group(n=30)by random number table method.PFNA group was treated with PFNA fixation,FHR group was treated with FHR.The intraoperative and postoperative indexes,postoperative complications and hip function were compared between the two groups.Results:The operative time of PFNA group was shorter than that of FHR group,the amount of intraoperative blood loss was less than that of FHR group,and the number of intraoperative fluoroscopy was more than that of FHR group(P<0.05).PFNA group was less than FHR group,the first time of getting out of bed after surgery was later than FHR group,and the hospital stay was longer than FHR group(P<0.05).The incidence of postoperative complications in FHR group was lower than that in PFNA group(P=0.041).Before operation,there was no significant difference in Harris score between the two groups(P>0.05);at 1,3 and 6 months after operation,the Harris scores of both groups were increased(P<0.05);the Harris scores of FHR group were higher than those of PFNA group 1 and 3 months after operation(P<0.05);6 months after surgery,there was no significant difference in Harris score between the two groups(P>0.05).Conclusion:For elderly patients with unstable intertrochanteric fractures of femur,FHR treatment is more effective,with fewer intraoperative fluoroscopy times,faster postoperative recovery,lower risk of complications,and better early recovery of hip function.However,PFNA fixation has shorter operative time,less intraoperative blood loss and less postoperative drainage.

关 键 词：股骨粗隆间骨折 股骨近端防旋髓内钉 人工股骨头置换术 老年人 

分 类 号：R687.3[医药卫生—骨科学]