摘要
目的观察股骨近端防旋髓内钉(PFNA)内固定术治疗股骨粗隆间骨折的临床疗效。方法选取2015年1月—2018年12月灌云县人民医院骨二科收治的102例股骨粗隆间骨折患者,随机分为对照组和观察组,每组51例。观察组给予PFNA内固定术治疗,对照组给予动力髋螺钉(DHS)内固定术治疗。观察两组患者近期效应(切口长度、术中出血量、手术时间)和远期效应(骨折愈合时间、Harris评分判定手术治疗效果和不良反应发生情况)。结果观察组切口长度、术中出血量、手术时间及骨折愈合时间分别为(3.24±0.992)cm、(170.14±15.349)mL、(69.51±5.194)min、(9.75±1.742)周,对照组分别为(6.43±1.616)cm、(220.18±15.998)mL、(93.63±6.184)min、(14.59±2.012)周,两组患者4个观察指标比较均差异有统计学意义(P<0.001)。治疗前观察组和对照组Harris评分分别为(34.51±2.921)分、(34.92±3.104)分,治疗后Harris评分分别为(90.78±4.041)分、(73.86±4.069)分,均较治疗前提高,观察组提高更显著(P<0.001)。观察组总有效率为94.12%(48/51),显著高于对照组的76.47(39/51)(χ^2=6.311,P=0.012)。观察组并发症发生率为3.92%(2/51),明显低于对照组的21.57%(11/51)(χ^2=7.141,P=0.008)。结论PFNA内固定术治疗股骨粗隆间骨折患者,术中出血量少,手术时间和骨折愈合时间短,明显提高Harris评分,手术治疗效果显著,值得临床借鉴。
Objective To observe the clinical effect of proximal femoral nail fixation(PFNA)for the treatment of femoral intertrochanteric fractures.Methods A total of 102 patients with femoral intertrochanteric fractures admitted to the Department of Orthopaedics,Guanyun County People's Hospital from January 2015 to December 2018 were randomly divided into the control group and the observation group,with 51 cases in each group.The observation group was treated with PFNA internal fixation and the control group was treated with dynamic hip screw(DHS)internal fixation.The short-term effects(incision length,intraoperative blood loss,operation time)and long-term effects(fracture healing time,Harris score to determine the surgical treatment effect and adverse reactions)were observed.Results The length of incision,intraoperative blood loss,operation time and fracture healing time were(3.24±0.992)cm,(170.14±15.349)mL,(69.51±5.194)min,(9.75±1.742)weeks,respectively;the control group of(6.43±1.616)cm,(220.18±15.998)mL,(93.63±6.184)min,and(14.59±2.012)weeks,there were significant differences in the four observations between the two groups(P<0.001).Before treatment,the Harris scores of the observation group and the control group were(34.51±2.921)points and(34.92±3.104)points respectively.The Harris scores after treatment were(90.78±4.041)points and(73.86±4.069)points,respectively.The observation group increased more significantly(P<0.001).The total effective rate of the observation group was 94.12%(48/51),which was significantly higher than that of the control group 76.47(39/51)(χ^2=6.311,P=0.012).The complication rate in the observation group was 3.92%(2/51),which was significantly lower than that in the control group 21.57%(11/51)(χ^2=7.141,P=0.008).Conclusion PFNA internal fixation for the treatment of femoral intertrochanteric fractures,the amount of intraoperative blood loss,surgery time and fracture healing time is short,significantly improve the Harris score,surgical treatment is significant,worthy of clinical reference.
作者
孙海东
SUN Hai-dong(Department of Orthopaedics,Guanyun County People's Hospital,Guanyun,Jiangsu Province,222200 China)
出处
《系统医学》
2019年第23期74-76,共3页
Systems Medicine
关键词
PFNA内固定术
DHS内固定术
股骨粗隆间骨折
疗效
PFNA internal fixation
DHS internal fixation
Femoral intertrochanteric fracture
Curative effect
