摘要
目的 探讨老年股骨粗隆间骨折患者应用股骨近端防旋髓内钉(PFNA)治疗的疗效。方法 选取股骨粗隆间骨折患者134例,根据手术方式的不同,将患者分为观察组66例(实施PFNA内固定治疗方案)、对照组68例[实施股骨近端锁定钢板(PFLP)治疗方案]。比较2组围术期指标情况、关节功能(Harris)评分、日常生活自理能力(ADL)评分、康复指标、并发症发生率。结果 观察组围术期各指标均优于对照组,差异有统计学意义(P<0.05);观察组术后1、2个月Harris评分优于对照组,差异有统计学意义(P<0.05);观察组术后1、2、3个月ADL评分均优于对照组,差异有统计学意义(P<0.05)。观察组住院时间、开始下床活动时间均短于对照组,差异有统计学意义(P<0.05);观察组骨折愈合时间略短于对照组(P>0.05)。观察组并发症总发生率为6.06%,低于对照组的20.59%,差异有统计学意义(P<0.05)。结论 PFNA与PFLP应用于老年股骨粗隆间骨折,均具有较好的治疗效果,而PFNA内固定治疗综合疗效优于PFLP内固定治疗,且PFNA内固定术后早期关节生理功能恢复更快。
Objective To observe the effect of internal fixation with proximal femoral nail antirotation(PFNA) in the treatment of elderly patients with femoral intertrochanteric fracture. Methods A total of 134 patients with femoral intertrochanteric fracture were selected and randomly divided into observation group(66 cases, treated with internal fixation with PFNA) and control group [68 cases, treated with proximal femoral locking plate(PFLP)]. The perioperative indexes, score of joint function(Harris score), score of activities of daily living(ADL), rehabilitation indexes and complications were compared between the two groups. Results The perioperative indexes of the observation group were significantly better than those of the control group(P<0.05);the Harris scores at 1 month and 2 months after operation in the observation group were significantly better than those in the control group(P<0.05);the ADL scores at 1 month, 2 month and 3 months after operation in the observation group were significantly better than those in the control group(P<0.05). The hospital stay and time to bed-off activity in the observation group were significantly shorter than those in the control group(P<0.05);the fracture healing time in the observation group was slightly shorter than that in the control group(P>0.05). The total incidence of complications in the observation group was 6.06%, which was significantly lower than 20.59% in the control group(P<0.05). Conclusion Both PFNA and PFLP can effectively treat the elderly patients with femoral intertrochanteric fracture, but the internal fixation with PFNA is better than the internal fixation with PFLP in comprehensive efficacy,and physiological function of joint recovers faster in the early stage after internal fixation with PFNA.
作者
黄叶建
陶明高
颜世显
耿玉强
HUANG Yejian;TAO Minggao;YAN Shixian;GENG Yuqiang(Department of Spine and Traumatic Orthopedics,Lianyungang City Oriental Hospital in Jiangsu Province,Lianyungang,Jiangsu,222042)
出处
《实用临床医药杂志》
CAS
2022年第4期64-67,共4页
Journal of Clinical Medicine in Practice
关键词
股骨粗隆间骨折
股骨近端防旋髓内钉
股骨近端锁定钢板
关节功能
日常生活自理能力
femoral intertrochanteric fracture
proximal femoral nail antirotation
proximal femoral locking plate
joint function
activities of daily living
