解剖型锁定钢板内固定与股骨近端防旋髓内钉治疗粗隆间骨折疗效比较研究

目的探讨解剖型锁定钢板内固定(LCP)和股骨防旋近端髓内钉(PFNA)治疗股骨粗隆间骨折临床疗效。方法选取2013年1月~2014年6月笔者医院收治的120例股骨粗隆骨折患者,依据治疗方法分为对照组(解剖型锁定钢板,n=60)和观察组(股骨近端防旋髓内钉,n=60)。比较两组患者的手术相关临床指标、术后恢复情况、临床疗效以及术后并发症情况。结果观察组患者切口长度、手术时间、术中以及术后出血量[(7.0±1.1)cm、(70.2±10.2)min、(136.3±43.2)m L和(160.3±50.2)m L]均低于对照组患者[(13.7±1.3)cm、(98.5±15.3)min、(185.3±64.3)m L和(240.4±64.3)m L],P0.05;观察组患者住院时间、下床时间、骨折愈合时间以及术后早期锻炼时间[(10.3±2.3)d、(10.4±1.2)d、(10.4±1.0)d和(6.3±2.3)d]均低于对照组患者[(20.1±3.2)d、(28.3±4.3)d、(14.1±1.2)d和(11.4±5.3)d],P0.05;观察组患者临床疗效(96.7%)优于对照组患者(88.3%,P0.05);观察组患者术后并发症发生率(3.3%)低于对照组患者(20.0%),P0.05。结论股骨近端防旋髓内钉治疗股骨粗隆间骨折临床疗效显著,创伤小,术后恢复快,骨折愈合时间短,并发症少,值得临床推广应用。

A comparative study of early clinical efficacy within the proximal femur intertrochanteric fracture fixation and anti-rotation nail(PFNA) in the treatment of intertrochanteric fracture

Objective To investigate the clinical efficacy of the anatomical locking plate fixation and proxi -mal femoral anti-rotation nail for the treatment of intertrochanteric fracture .Methods According to the treatment methods,120 patients with intertrochanteric fractures were divided into the control group ( anatomical locking plate fixation) and the observation group (proximal femoral anti-rotation nail).The surgery-related clinical indicators, postoperative recovery ,clinical efficacy and postoperative complications were compared between the two groups .Re-sults The incision length,operative time,intra-operative and postoperative bleeding volume of the observation group [(7.0 ±1.1)cm,(70.2 ±10.2)min,(136.3 ±43.2)mL and (160.3 ±50.2)mL] were significantly lower than those of the control group[(13.7 ±1.3)cm,(98.5 ±15.3)min,(185.3 ±64.3)mL and (240.4 ±64.3)mL,(P<0.05)];the hospitalization time,bed time,healing time,and early postoperative exercise time of the observation group[(10.3 ±2.3)d,(10.4 ±1.2)d,(10.4 ±1.0)d and (6.3 ±2.3)d] were significantly less than those the control group[(20.1 ±3.2)d,(28.3 ±4.3)d,(14.1 ±1.2) and (11.4 ±5.3)d,(P<0.05)];the clinical effi-cacy rate of the observation group (96.7%) was better than that of the control group (88.3%,P<0.05);the inci-dence of postoperative complications in the observation group (3.3%) was significantly lower than the control group (20.0%,P<0.05).Conclusion The proximal femoral anti-rotation nail in the treatment of intertrochanteric fracture can achieve significant clinical effects ,which has advantages of less invasive ,rapid postoperative recovery , short healing time ,and less complications .It is worthy of clinical application .