防旋髓内钉联合健步虎潜膏治疗高龄股骨转子间骨折伴骨质疏松症患者临床研究

目的 评价防旋髓内钉联合健步虎潜膏治疗高龄股骨转子间骨折伴骨质疏松症患者的疗效.方法 将符合入选标准的高龄骨质疏松症患者单侧股骨转子间骨折85例,采用随机数字表法分为对照组45例和观察组40例.2组患者均行股骨近端防旋髓内钉内固定治疗,观察组在此基础上联用健步虎潜膏治疗.2组均连续观察6个月.采用VAS量表评价患者疼痛程度,采用Harris髋关节评分表评价髋关节功能,比较治疗前后股骨粗隆及Ward区的骨密度差异,记录骨痂出现时间、下地行走时间、骨折愈合时间及并发症.结果 观察组VAS疼痛评分在治疗后1周(6.2±1.6)分比(7.9±1.6)分,t=3.683]、3周(3.1±1.1)分比(5.4±1.4)分,t=4.239]、7周(2.3±0.9)分比(4.0±1.3)分,t=3.571]时低于对照组(P<0.05);骨痂出现时间(42.4±5.9)d比(49.2±6.2)d,t=4.139]、下地行走时间(6.9±1.1)周比(8.7±1.2)周,t=3.695]、骨折愈合时间(13.6±2.2)周比(16.2±3.1)周,t=3.473]均较对照组缩短(P<0.05);Harris髋关节评分(89.8±7.2)分比(81.4±5.9)分,t=3.728]高于对照组(P<0.05);股骨粗隆骨密度(0.782±0.142)g/cm2比(0.691±0.135)g/cm2,t=3.759]、Ward三角区骨密度(0.628±0.071)g/cm2比(0.513±0.059)g/cm2,t=4.386]高于对照组(P<0.05);观察组与治疗后并发症发生率为15.0%(6/40)、对照组为37.8%(17/45),2组比较差异有统计学意义(χ2=5.567,P<0.05).结论 健步虎潜膏联合防旋髓内钉可减轻高龄股骨转子间骨折伴骨质疏松症患者疼痛程度,促进骨折愈合,有效预防术后并发症.

The effect of Jianbu-huqian ointment combined with proximal femoral nail antirotation for the elderly patients with intertrochanteric fracture of femur with osteoporosis

Objective To explore the effect of Jianbu-Huqian ointment combined with proximal femoral nail antirotation for the elderly patients with intertrochanteric fracture of femur with osteoporosis. Methods A total of 85 elderly patients with intertrochanteric fracture of femur with osteoporosis were randomly divided into the control group (40 patients) and the observation group (45 patients. Both groups of patients were treated with proximal femoral nail antirotation, and the observation group was added with Jianbu-Huqian ointment. The pain, fracture healing, joint function, bone mineral density and complications were compared between the two groups. Results The VAS pain score at 1st week (6.2 ± 1.6 vs. 7.9 ± 1.6; t=3.683, P<0.05), 3rd week (3.1 ± 1.1 vs. 5.4 ± 1.4; t=4.239, P<0.05) and 7th week (2.3 ± 0.9 vs. 4.0 ± 1.3; t=3.571, P<0.05) after operation of the observation group were significantly lower than those of the control group. The occurrence time (42.4 ± 5.9 d vs. 49.2 ± 6.2 d; t=4.139, P<0.05), walking time (6.9 ± 1.1 weeks vs. 8.7 ± 1.2 weeks;t=3.695, P<0.05), fracture healing time (13.9 ± 2.2 weeks vs. 16.2 ± 3.1 weeks, t=3.473, P<0.05) of the observation group were significantly lower than those of the control group. Harris hip score (89.8 ± 7.21 vs. 81.4 ± 5.93; t=3.728, P<0.05) in the observation group was significantly higher than that in the control group. The bone density of the femur (0.782 ± 0.142 g/cm2 vs. 0.691 ± 0.135 g/cm2; t=3.759, P<0.05) and the area of ward (0.628 ± 0.071 g/cm2 vs. 0.513 ± 0.059 g/cm2; t=4.386, P<0.05) of the observation group were significantly lower than those of the control group. The incidence of postoperative complications in the observation group was 15.0%(6/40), and the control group was 37.8% (17/45). The difference was statistically significant (χ2=5.567, P<0.05). Conclusions The Jianbu-Huqian ointment combined with proximal femoral nail antirotation could reduce the pain, promote fracture healing, and prevent the occurrence of postoperative complications for the elderly patients with intertrochanteric fracture of femur with osteoporosis.