PFNA治疗对老年严重骨质疏松不稳定型股骨转子间骨折患者骨折愈合情况的影响  

The Effect of PFNA Treatment on Fracture Healing in Elderly Patients With Severe Osteoporosis and Unstable Intertrochanteric Fractures

作　　者：何啸波 高玉新 吴增良[1] HE Xiaobo;GAO Yuxin;WU Zengliang(Department of Orthopedics,Jiangdu Traditional Chinese Medicine Hospital,Yangzhou,Jiangsu 225200,China)

机构地区：[1]扬州市江都中医院骨伤科,江苏扬州225200

出　　处：《中国医药指南》2025年第6期49-52,共4页Guide of China Medicine

摘　　要：目的探讨股骨近端防旋髓内钉(PFNA)内固定治疗对老年严重骨质疏松不稳定型股骨转子间骨折患者骨折愈合情况的影响。方法选择2020年1月至2023年1月扬州市江都中医院接诊的92例老年严重骨质疏松不稳定型股骨转子间骨折患者为研究对象,依据不同手术方式分组,对照组(n=46)股骨近端锁定板治疗,观察组(n=46)PFNA治疗,对比两组围手术期指征、髋关节功能、骨折愈合情况、并发症。结果观察组手术时间、术后部分负重时间短于对照组,术中出血量低于对照组(P<0.05);术后20个月两组HHS评分逐渐提升,观察组高于对照组(P<0.05);观察组骨折愈合时间短于对照组,骨折愈合优良率高于对照组(P<0.05);观察组术后延迟愈合等并发症发生率低于对照组(P<0.05)。结论PFNA内固定治疗老年严重骨质疏松不稳定型股骨转子间骨折可有效缩短手术时间、减少出血量、加快患者术后部分负重时间,提升髋关节功能评分,促进骨折愈合并提高愈合优良率,同时降低延迟愈合等并发症的发生风险。Objective To investigate the effect of proximal femoral anti rotation intramedullary nail(PFNA)internal fixation on fracture healing in elderly patients with severe osteoporosis and unstable intertrochanteric fractures.Methods Ninety two elderly patients with severe osteoporosis and unstable intertrochanteric fractures who were admitted in Jiangdu Traditional Chinese Medicine Hospital from January 2020 to January 2023 were selected as the subjects.Grouped according to the different surgical methods,The control group(n=46)received proximal femoral locking plate treatment,while the observation group(n=46)received PFNA treatment.The perioperative indications,hip joint function,fracture healing,and complications were compared between the two groups.Results The observation group had shorter surgical time and postoperative partial weight-bearing time compared to the control group,and lower intraoperative blood output(P<0.05).20 months after surgery,the HHS scores of the two groups gradually improved,with the observation group higher than the control group(P<0.05).The observation group had a shorter fracture healing time and a higher rate of excellent fracture healing than the control group(P<0.05).The incidence of postoperative complications such as delayed healing in the observation group was lower than that in the control group(P<0.05).Conclusions PFNA internal fixation treatment for elderly patients with severe osteoporosis and unstable intertrochanteric fractures can effectively shorten surgical time,reduce bleeding,accelerate postoperative partial weight-bearing time,improve hip joint function scores,promote fracture healing and improve the rate of excellent healing,while reducing the risk of complications such as delayed healing.

关 键 词：股骨近端防旋髓内钉内固定 老年骨质疏松 股骨转子间骨折 骨折愈合 髋关节功能 

分 类 号：R683.42[医药卫生—骨科学]