摘要
目的观察老年股骨粗隆间骨折不同类型进行股骨近端防旋髓内钉(PFNA)与股骨近端锁定解剖板(LPFP)内固定术治疗的临床效果和并发症研究。方法选取南阳市中心医院2020年2月至2022年2月收治的76例老年股骨粗隆间骨折不同类型患者,根据治疗方式的不同分组,分为对照组(N=38)、观察组(N=38),观察组进行股骨近端防旋螺内钉(PFNA)内固定术治疗,对照组进行股骨近端锁定解剖板(LPFP)内固定术治疗。分析两组临床指标(骨折愈合时间、住院时间、下床负重时间、术中出血量、切口长度、手术时间);分析两组治疗前后的世界卫生组织生存质量测定简表(WHOQOL-BREF评分)、Harris-髋关节功能评分;分析两组术后载荷800 N时压缩移位、载荷800 N时压缩刚度、扭转1.5°扭矩、扭转1.5°时扭转刚度;分析两组的术后并发症情况。结果观察组临床指标(骨折愈合时间、住院时间、下床负重时间、术中出血量、切口长度、手术时间)优于对照组,差异有统计学意义(P<0.05);与术前相比,两组术后的世界卫生组织生存质量测定简表(WHOQOL-BREF评分)、Harris-髋关节功能评分均有增高,且观察组高于对照组,差异有统计学意义(P<0.05);与术前相比,两组载荷800 N时压缩移位均有下降,术后载荷800 N时压缩刚度、扭转1.5°扭矩、扭转1.5°时扭转刚度均有增高,且术后观察组载荷800 N时压缩移位低于对照组,载荷800N时压缩刚度、扭转1.5°扭矩、扭转1.5°时扭转刚度高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率(术后尿路感染、下肢静脉血栓、内固定松动、髋内翻、骨折延迟愈合)少于对照组,差异有统计学意义(P<0.05)。结论与LPFP内固定术相比,老年股骨粗隆间骨折不同类型PFNA内固定术可促进术后髋关节功能的恢复及加速骨折愈合,生物力学性能优越、操作简单、创伤性较小,并发症少。
Objective To observe the clinical effects and complications of different types of intertrochanteric fractures in the elderly treated with proximal femoral anti rotation nail(PFNA)and locking anatomical plate of proximal femur(LPFP).Methods A total of 76 elderly patients with femoral intertrochanteric fracture treated in Nanyang Central Hospital from February 2020 to February 2022 were divided into control group(N=38)and observation group(N=38)according to different treatment methods.The observation group was treated with internal fixation of PFNA,and the control group was treated with internal fixation of LPFP.The clinical indexes of the two groups(fracture healing time,hospitalization time,time to get out of bed and load,intraoperative blood loss,incision length,operation time)were analyzed;The WHO short form of quality of life(WHOQOL-BREF score)and Harris-hip function score were analyzed before and after treatment in the two groups;The compression displacement under 800 N load,the compression stiffness under 800 N load,the torsional stiffness under 1.5°torque and the torsional stiffness under 1.5°torque were analyzed;The postoperative complications of the two groups were analyzed.Results The clinical indexes(fracture healing time,hospitalization time,time to get out of bed and load,intraoperative blood loss,incision length,operation time)in the observation group were better than those in the control group,with a statistically significant difference(P<0.05);Compared with pre-operation,the WHO short table of quality of life(WHOQOL-BREF score)and Harris-hip joint function score of the two groups after operation were higher,and the observation group was higher than the control group,with a statistically significant difference(P<0.05);Compared with the pre-operation,the compression displacement of the two groups decreased when the load was 800 N,and the compression stiffness,the torsional stiffness under 1.5°torque,and the torsional stiffness under 1.5°torque of the two groups increased when the load was 800 N,and the compression displacement of the observation group was lower when the load was 800 N,and the compression stiffness,the torsional stiffness under 1.5°torque,and the torsional stiffness under 1.5°torque of the observation group were higher when the load was 800 N than those of the control group(P<0.05);The incidence of complications(postoperative urinary tract infection,lower limb vein thrombosis,internal fixation loosening,coxa vara,delayed fracture healing)in the observation group was less than that in the control group,with a statistically significant difference(P<0.05).Conclusion Compared with LPFP internal fixation,different types of PFNA internal fixation for intertrochanteric fracture of femur in the elderly can promote the recovery of hip joint function and accelerate fracture healing after operation,with superior biomechanical performance,simple operation,less trauma and fewer complications.
作者
吴茗莎
WU Mingsha(Department of Orthopedics,Nanyang Central Hospital,Nanyang Henan 473005,China)
出处
《临床研究》
2022年第11期106-110,共5页
Clinical Research
