比较两种髓内钉置入修复骨质疏松性股骨转子间骨折的并发症发生率

背景：近年来动力髋螺钉受到人们的重视，且国际内固定研究学会改进的防旋型股骨近端髓内钉也被逐渐应用于临床，其疗效也得到了广泛的肯定。 目的：分析股骨近端髓内钉及股骨近端防旋髓内钉置入内固定修复老年骨质疏松性股骨转子间骨折的并发症发生率。 方法：选取禹城市人民医院2012年6月至2014年6月收治的70例老年骨质疏松性股骨转子间骨折患者，采取随机数字表法分为对照组与试验组，每组35例。对照组给予股骨近端髓内钉置入内固定，试验组给予股骨近端防旋髓内钉置入内固定，对比两组患者手术时间、术中出血量、骨折愈合时间、内固定后并发症及髋关节功能Harris评分情况。 结果与结论：两组患者在手术时间上差异有显著性意义，试验组较对照组手术时间短(t=2.88，P < 0.05)。对照组内固定后总并发症发生率为26%，试验组内固定后总并发症发生率为9%，两组比较差异有显著性意义 (χ2=4.77，P < 0.05)。提示股骨近端髓内钉及股骨近端防旋髓内钉置入内固定在修复老年骨质疏松性股骨转子间骨折时均具有创伤小、固定牢固等特点，但与股骨近端髓内钉相比，股骨近端防旋髓内钉在缩短手术时间、降低内固定后并发症方面具有突出的优势。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：

Complication of two intramedullary nail treatments of osteoporotic intertrochanteric fractures

BACKGROUND: Dynamic hip screws have developed in recent years, and proximal femoral nail anti-rotation modified by the Association for the Study of Internal Fixation has been widely applied in clinics. Their efficacy has been well recognized. OBJECTIVE:To analyze and compare the complications of proximal femur intramedullary nail and proximal femoral nail anti-rotation treatments in elderly patients with osteoporotic intertrochanteric fracture. METHODS: Seventy elderly patients with osteoporotic intertrochanteric fracture were selected from the People’s Hospital of Yucheng City between June 2012 and June 2014. Patients were randomly divided into two groups: control group and experimental group, with 35 cases in each group. Control group was given proximal femur intramedullary nail treatment, while experimental group was given the proximal femoral nail anti-rotation treatment. The operation time, intraoperative blood loss, fracture healing time, postoperative complications and  hip Harris score were compared in two groups. RESULTS AND CONCLUSION: The operation time in the experimental group was significantly shorter than that in the control group (t=2.88, P < 0.05). The postoperative complication rate was 26% in control group and 9% in experimental group, with significant differences in the two groups (χ2 = 4.77, P < 0.05). Both proximal femur intramedullary nail and proximal femoral nail anti-rotation have few trauma and strong fixation for the treatment of osteoporotic intertrochanteric fractures, and proximal femoral nail anti-rotation has a shorter operation time and reduces postoperative complications.