PFNA-Ⅱ内固定对外壁危险型转子间骨折患者的治疗效果  

Effect of PFNA-ⅡInternal Fixation in Patients with Dangerous Intertrochanteric Fractures of the Outer Wall

作　　者：袁永勋 田超[1] 王红升[1] YUAN Yongxun;TIAN Chao;WANG Hongsheng(Orthopedic Department Second Ward,Affiliated Traditional Chinese Medicine Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校附属中医院骨伤科二病区,河南南阳473000

出　　处：《河南医学研究》2025年第7期1275-1279,共5页Henan Medical Research

摘　　要：目的探讨骨近端防旋髓内钉-Ⅱ(PFNA-Ⅱ)内固定治疗外壁危险型转子间骨折患者的效果。方法选取南阳医学高等专科学校附属中医院2020年1月至2023年1月收治的86例外壁危险型转子间骨折患者,按照治疗方式分为PFNA-Ⅱ组(PFNA-Ⅱ内固定,41例)和动力髋螺钉(DHS)组(DHS内固定,45例),比较两组围手术期相关指标,术前、术后6个月的Harris髋关节评分(HHS)和世界卫生组织生存质量简表(WHOQOL-BREF)各维度评分,以及并发症发生情况。结果与DHS组比较,PFNA-Ⅱ组手术时间、切口长度、术后完全负重时间、骨折愈合时间更短(P<0.05),PFNA-Ⅱ组术中出血量更多(P<0.05)。与术前比较,两组术后6个月HHS各维度评分升高(P<0.05),且与DHS组比较,PFNA-Ⅱ组术后6个月活动范围、功能、疼痛评分更高(P<0.05)。与术前比较,两组术后6个月WHOQOL-BREF各维度评分升高(P<0.05),且与DHS组比较,PFNA-Ⅱ组术后6个月活WHOQOL-BREF各维度评分更高(P<0.05)。与DHS组的并发症26.67%比较,PFNA-Ⅱ组的9.76%更低(P<0.05)。结论PFNA-Ⅱ内固定治疗外壁危险型转子间骨折,可有效促进髋关节功能恢复,提高生活质量,减少并发症发生,促进患者更快康复。Objective To investigate the effect of proximal femoral nail antirotationⅡ(PFNA-Ⅱ)internal fixation in patients with external wall dangerous intertrochanteric fractures.Methods From January 2020 to January 2023,86 patients with dangerous intertrochanteric fractures on the outer wall of the Affiliated Traditional Chinese Medicine Hospital of Nanyang Medical College were selected and divided into PFNA-Ⅱgroup(PFNA-Ⅱinternal fixation,41 cases)and dynamic hip screw(dynamic hip screw,DHS)group(DHS internal fixation,45 cases).The perioperative indicators,Harris hip score(HHS)and World Health Organization quality of life-BREF(WHOQOL-BREF),as well as the occurrence of complications were compared between the two groups.Results Compared with the DHS group,the operation time,incision length,postoperative full weight-bearing time,and fracture healing time were shorter than those in the PFNA-Ⅱgroup(P<0.05),and the intraoperative blood loss was more than that in the PFNA-Ⅱgroup(P<0.05).HHS scores in each dimension increased at 6 months after surgery(P<0.05),and range of motion,function,and pain scores were higher in the PFNA-Ⅱgroup compared with the DHS group(P<0.05).The scores of all dimensions of WHOQOL-BREF in the two groups were increased 6 months after operation compared with those before operation(P<0.05),and the scores of all dimensions of WHOQOL-BREF in the PFNA-Ⅱgroup were higher than those in the DHS group(P<0.05).The incidence of complications in the PFNA-Ⅱgroup was lower than that in the DHS group(9.76%vs 26.67%)(P<0.05).Conclusion PFNA-Ⅱinternal fixation for external wall dangerous intertrochanteric fractures can effectively promote the recovery of hip joint function,improve the quality of life,reduce complications,and promote the faster recovery of patients.

关 键 词：外壁危险型转子间骨折 骨近端防旋髓内钉-Ⅱ 髋关节恢复 生活质量 

分 类 号：R687.3[医药卫生—骨科学]