摘要
目的比较股骨近端锁定钢板(LPFP)与股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折患者的效果。方法将2017年5月至2020年6月在湖州市菱湖人民医院就诊的老年股骨粗隆间骨折患者130例按照随机数字表法分为观察组(PFNA治疗)和对照组(LPFP治疗),每组65例。观察两组的术中出血量、切口长度、手术时间与骨折愈合时间,于术后1、3、6个月采用髋关节功能评分(Harris)评价患者的髋关节恢复情况,并比较两组髋内翻、切口感染、内固定松动等并发症发生情况。结果观察组术中出血量少于对照组[(189.26±48.15)mL比(96.47±40.21)mL],切口长度、手术时间、骨折愈合时间均短于对照组[(4.03±1.48)cm比(12.16±1.55)cm、(72.13±28.75)min比(120.34±29.01)min、(9.89±1.52)周比(13.63±1.74)周],差异均有统计学意义(t=-11.93、-30.59、-9.52、-13.05,均P<0.001)。两组术后1个月Harris评分差异无统计学意义(t=1.28,P>0.05),两组术后3、6个月Harris评分均逐步提高(F=13.44、8.26,均P<0.001),观察组术后3个月、6个月Harris评分均高于对照组[(85.17±4.29)分比(79.50±4.12)分,(95.30±1.04)分比(87.69±1.25)分](t=7.69、37.73,均P<0.001)。观察组并发症发生率为1.54%(1/65),明显低于对照组的10.77%(7/65)(χ^(2)=4.80,P=0.029)。结论相较于LPFP,PFNA能更有效减少老年股骨粗隆间骨折患者的术中出血量,加速骨折愈合进度,促进其髋关节的恢复,且并发症少,值得推广使用。
Objective To investigate the efficacy of a proximal femoral locking plate(LPFP)versus a proximal femoral anti-rotation intramedullary nail(PFNA)in the treatment of femoral intertrochanteric fractures in older adult patients.Methods A total of 130 older adult patients with femoral intertrochanteric fractures who received treatment in Linghu People's Hospital of Huzhou from May 2017 to June 2020 were included in this study.They were randomly assigned to undergo treatment with either a PFNA(observation group,n=65)or an LPFP(control group,n=65).Intraoperative blood loss,incision length,operative time,and time to fracture healing were determined in each group.At 1,3,and 6 months after surgery,the Harris hip score was used to evaluate hip joint recovery.Coxa vara,incision infection,and internal fixation loosening were compared between the two groups.Results Intraoperative blood loss in the observation group was less than that in the control group[(189.26±48.15)mL vs.(96.47±40.21)mL,t=-11.93,P<0.001].Incision length,operative time,and time to fracture healing in the observation group were significantly shorter than those in the control group[(4.03±1.48)cm vs.(12.16±1.55)cm,(72.13±28.75)minutes vs.(120.34±29.01)minutes,(9.89±1.52)weeks vs.(13.63±1.74)weeks,t=-30.59,-9.52,-13.05,all P<0.001].At 1 month after surgery,there was no significant difference in Harris hip score between the two groups(t=1.28,P>0.05).At 3 and 6 months after surgery,the Harris hip score gradually increased in the control and observation groups(F=13.44,8.26,both P<0.001).At 3 and 6 months after surgery,Harris hip scores in the observation group were significantly higher than those in the control group[(85.17±4.29)points vs.(79.50±4.12)points,(95.30±1.04)points vs.(87.69±1.25)points,t=7.69,37.73,both P<0.001].The incidence of complications in the observation group was significantly lower than that in the control group[1.54%(1/65)vs.10.77%(7/65),χ^(2)=4.80,P=0.029).Conclusion Compared with LPFP,PFNA can effectively reduce intraoperative blood loss in older adult patients with femoral intertrochanteric fractures,accelerate the progress of fracture healing,promote the recovery of the hip joint,and has fewer complications.Therefore,PFNA is worthy of popularization.
作者
费联成
泮海国
于金磊
Fei Liancheng;Pan Haiguo;Yu Jinlei(Department of Orthopedics,Linghu People's Hospital of Huzhou,Huzhou 313018,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2023年第3期375-378,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
股骨骨折
粗隆
骨折固定术
内
钢板
骨折固定术
髓内
髋关节功能
手术时间
愈合
术后并发症
老年人
Femoral fracture
Tuberosity
Fracture fixation,internal
Steel plate
Fracture fixation,intramedullary
Hip function
Operation time
Heal
Postoperative complications
Aged
