股骨近端防旋髓内钉内固定配合中药内服治疗老年股骨转子间骨折

目的：探讨股骨近端防旋髓内钉内固定配合中药内服治疗老年股骨转子间骨折的临床疗效。方法：老年股骨转子间骨折患者60例，随机分为2组，每组30例。分别采用股骨近端防旋髓内钉内固定配合中药内服治疗（手术＋中药组）和股骨近端防旋髓内钉内固定治疗（手术组）。随访观察并对比2组患者术后患肢肿胀消退及骨折愈合情况，参照Harris髋关节功能评分标准评价患肢髋关节功能。结果：2组患者均获随访，随访时间5～12个月，中位数7．5个月；术后患肢肿胀消退，骨折均愈合；手术＋中药组患肢肿胀消退时间和骨折愈合时间均较手术组短[（7．400±1．734）d，（8．400±1．101）d，t＝2．649，P＝0．013；（12．333±1．212）周，（13．200±1．186）周，t＝-2．832，P＝0．008]，Harris 髋关节功能评分较手术组高[（90．166±2．972）分，（87．133±5．090）分，t＝-2．467，P＝0．020]。结论：股骨近端防旋髓内钉内固定治疗老年股骨转子间骨折，固定可靠，配合中药内服较单纯手术治疗更有利于消除患肢肿胀、缩短骨折愈合时间、改善髋关节功能。

Study on the clinical therapeutic effect of proximal femoral nail anti-rotation internal fixation combined with oral application of traditional Chinese drug in the treatment of intertrochanteric fracture in aged patients

Objective：To evaluate the clinical therapeutic effect of proximal femoral nail anti-rotation（PFNA）internal fixation com-bined with oral application of traditional Chinese drug（TCD）in the treatment of intertrochanteric fracture in aged patients.Methods：Sixty aged patients with intertrochanteric fractures were randomly divided into 2 groups,30 cases in each group.The patients were treated with combination of PFNA internal fixation with oral application of TCD（operation ! TCD group）and PFNA internal fixation alone（operation group）respectively.The patients were followed up and the swelling subsidence and fracture healing for affected limbs were compared be-tween the 2 groups after treatment,and the hip joint function was evaluated according to the Harris Hip Score.Results：The patients in the 2 groups were followed up for 5 -12 months with a median of 7.5 months.The affected limb swelling subsided and fractures were healed in patients after the treatment.Both affected limb swelling subsidence time and fracture healing time were shorter in the operation ! TCD group compared to the operation group（7.400＋/-1.734 vs 8.400 ＋/-1.101 days,t=2.649,P=0.013;12.333 ＋/-1.212 vs 13.200＋/-1.186 weeks,t=-2.832,P=0.008）,while the Harris scores of hip joint function were higher in the operation ! TCD group com-pared to the operation group（90.166＋/-2.972 vs 87.133＋/-5.090 points,t=-2.467,P=0.020）.Conclusion：The therapy of PFNA internal fixation has reliable fixation effect in the treatment of intertrochanteric fracture in aged patients,and combined with oral application of TCD,it is more conducive to eliminate the limb swelling,shorten the fracture healing time and improve the hip joint function than the monotherapy of surgery.