小切口微创治疗难复型股骨转子间骨折的疗效观察

目的 探讨髋部前外侧小切口手术入路复位方式利用PFNA内固定治疗难复型股骨转子间骨折患者的临床疗效。方法 选取2017年5月至2021年5月湖南省湘西自治州人民医院的老年难复型股骨转子间骨折患者共34例，其中髋部前外侧小切口组19例（行髋部前外侧小切口PFNA内固定手术），常规外侧大切口组15例（行常规外侧大切口PFNA内固定手术）。比较两组患者的手术时间、切口长度、术中出血量、早期下床活动时间、术后疼痛评分等相关数据。结果 所有患者均获得随访6 ～ 10个月，平均随访（8.12±1.64）个月。髋部前外侧小切口组患者的手术时间、术中出血量、手术切口长度、早期下床活动时间、术后疼痛评分优于常规外侧大切口组，两组间比较差异有统计学意义（P＜0.05）。结论 对于老年难复型股骨转子间骨折患者，髋部前外侧微创切口PFNA手术治疗难复位型股骨转子间骨折的方式术中出血量少，手术创伤小，患者的术后疼痛低，术后下床活动时间早，安全性大大提高。

Observation on the curative effect of small incision minimally invasive treatment of refractory intertrochanteric fracture of femur

Objective To investigate the clinical efficacy of PFNA internal fixation in the treatment of refractory intertrochanteric fractures of the femur.Methods A total of 34 elderly patients with refractory intertrochanteric fracture of femur hospitalized in Hunan Xiangxi Autonomous Prefecture People''s Hospital from May 2017 to May 2021 were selected, including 19 cases in the anterolateral small incision group of hip (PFNA internal fixation with anterolateral minimally invasive incision of hip was performed in this group) and 15 cases in the conventional lateral large incision group (conventional large lateral incision PFNA internal fixation was performed in this group). The operation time, incision length, intraoperative bleeding, early ambulation time, postoperative pain score and other related data of the two groups were compared.Results All the patients were followed up for 6-10 months, with an average of (8.12±1.64) months. The operation time, intraoperative bleeding, incision length, early ambulation time, postoperative pain score of patients in the anterolateral small incision group of hip were better than those in the conventional large incision group, and the difference between the two groups was statistically significant (P<0.05).Conclusion For the elderly patients with refractory intertrochanteric fractures, PFNA with anterolateral minimally invasive hip incision can achieve good results in the treatment of refractory intertrochanteric fractures. This treatment method has less intraoperative bleeding, less surgical trauma, low postoperative pain, early postoperative ambulation, and greatly improved safety.