[1]王小波,李雪飞,白晓彬.股骨近端防旋髓内钉治疗老年股骨转子间骨折的临床疗效观察[J].中华老年骨科与康复电子杂志,2018,(03):158-162.[doi:10.3877/cma.j.issn.2096-0263.2018.03.007]
　Wang Xiaobo,Li Xuefei,Bai Xiaobin.Clinical observation of proximal femoral nail anti rotation intramedullary nail (PFNA) in the treatment of intertrochanteric fractures in the elderly[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(03):158-162.[doi:10.3877/cma.j.issn.2096-0263.2018.03.007]
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股骨近端防旋髓内钉治疗老年股骨转子间骨折的临床疗效观察()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2018年03期
页码:
158-162
栏目:
髋关节
出版日期:
2018-05-23

文章信息/Info

Title:
Clinical observation of proximal femoral nail anti rotation intramedullary nail (PFNA) in the treatment of intertrochanteric fractures in the elderly
作者:
王小波; 李雪飞; 白晓彬
408000 重庆涪陵李志沧中医骨伤医院骨科一病区
Author(s):
Wang Xiaobo;  Li Xuefei;  Bai Xiaobin
Department of First Orthopedics, Li Zhicang Orthopedic Hospital of Fuling District, Chongqing 408000, China
关键词:
髋骨折;  老年人;  股骨近端防旋髓内钉
Keywords:
Hip fractures;  Aged;  Proximal femoral nail anti-rotation
DOI:
10.3877/cma.j.issn.2096-0263.2018.03.007
文献标志码:
A
摘要:
目的 观察股骨近端防旋髓内钉（PFNA）治疗老年股骨转子间骨折的临床疗效。方法 前瞻性收集2015年1月至2017年1月重庆涪陵李志沧中医骨伤医院收治的老年股骨转子间骨折患者100例，按照随机数字表法分为对照组与观察组，各50例。观察组患者采取PFNA进行治疗，对照组患者采取股骨近端髓内钉（PFN）进行治疗。观察两组患者术中及术后的各项临床指标、髋关节Harris评分优良率及术后并发症情况。结果 所有患者均获得满意随访，随访时间为3～6个月，平均（4.3±0.8）个月。观察组患者的切口长度为（6.4±2.5）cm、手术时间为（69±10）min、术中出血量为（162±46）ml、住院时间为（18±3）d、术后负重时间为（14±4）d，均优于对照组的（11.2±2.3）cm、（77±11）min、（210±80）ml、（21±5）d、（17±4）d，差异均有统计学意义（P＜0.05）；两组患者骨折愈合时间比较差异无统计学意义。观察组患者的髋关节功能恢复优良率[86.0%（43/50）]高于对照组[68.0%（34/50）]，差异有统计学意义（c2=32.654，P＜0.05）。观察组患者的术后并发症发生率[6.0%（3/50）]低于对照组[18.0%（9/50）]，差异有统计学意义（c2=12.657，P＜0.05）。结论 采取PFNA治疗老年股骨转子间骨折，不仅具有创伤小、手术操作时间短，术后恢复快等临床特征，且能够显著提高患者的髋关节功能恢复效果，减少并发症的发生率，具有确切的临床疗效和较高的临床治疗安全性。
Abstract:
Objective To observe the effect of proximal femoral nail anti rotation (PFNA) clinical curative effect in the treatment of intertrochanteric fractures in the elderly. Methods A total of 100 patients with intertrochanteric femoral fractures treated in our hospital from January 2015 to January 2017 were prospectively collected. According to the random number table method, they were divided into control group and observation group, 50 cases in each group. The observation group was treated with PFNA, and the control group was treated with PFN. The intraoperative and postoperative complications and Harris hip score and excellent rate after operation were compared between two groups. Results All patients obtained satisfactory follow-up, follow-up time was 3-6 months, with an average of (4.3±0.8) months. The incision length in observation group was (6.4±2.5) cm, the operation time was (69±10) min, the amount of bleeding was (162±46) ml, hospitalization time was (18±3) d, postoperative weight-bearing time was (14±4) d, all superior to the control group (11.2±2.3) cm, (77±11) min, (210±80) ml, (21±5) d, (17±4) d, differences were statistically significant between two groups (P<0.05), healing time was no statistically significant difference between two groups. The recovery rate of the observation group [86.0% (43/50)] was significantly higher than the control group [68.0% (34/50)], the difference was statistically significant (c2=32.654, P<0.05). The incidence of postoperative complications in the observation group [6.0% (3/50)] was significantly lower than the control group [18.0% (9/50)], difference was statistically significant (c2=12.657, P<0.05). Conclusions The treatment of femoral intertrochanteric fracture in the elderly with anti-rotation nail in the proximal femur not only has the characteristics of less trauma, shorter operation time, faster postoperative recovery, but also can significantly improve the recovery of hip function and reduce complications. The incidence rate has exact clinical efficacy and high clinical safety.

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更新日期/Last Update: 2018-05-22