摘要
目的对比在股骨粗隆间骨折的治疗上分别使用加长型股骨近端防旋髓内钉(PFNA)内固定与闭合复位PFNA内固定治疗疾病的效果。方法将2016年1月-2019年6月收治的41例粗隆间骨折患者根据骨折分型,将21例不稳定型骨折患者分成观察组,20例稳定型骨折分成对照组,对照组使用闭合复位PFNA内固定治疗,观察组使用加长型PFNA内固定治疗,观察两组治疗效果。结果观察组患者手术时间、骨折愈合时间及功能恢复时间分别为(72.26±7.06)min、(4.61±0.71)周、(5.01±0.81)周,对照组分别为(55.26±6.28)min、(3.25±0.57)周、(3.75±0.66)周,观察组各时间指标明显比对照组长(t=8.131、6.742、5.444,P=0.000、0.000、0.000),观察组术中出血量为(135.56±16.28)mL,明显比对照组(112.24±14.48)mL多,均差异有统计学意义(t=4.837,P=0.000);观察组治疗后总有效率为71.43%,明显低于对照组95.00%的总有效率(χ^2=4.020,P=0.045);术后随访观察组患者并发症发生率为28.57%,明显高于对照组5.00%的发生率(χ^2=4.020,P=0.045)。结论对股骨粗隆间骨折,采取加长型PFNA内固定治疗具有手术时间长、出血量多、术后并发症多的特点,常用于治疗不稳定型的股骨粗隆间骨折,而对稳定型的骨折可采取常规闭合复位PFNA内固定的治疗方式。
Objective To compare the effects of long-term femoral proximal anti-rotation intramedullary nail(PFNA) internal fixation and closed reduction PFNA internal fixation in the treatment of femoral intertrochanteric fractures. Methods Forty-one patients with intertrochanteric fractures admitted from January 2016 to June 2019 were divided into observation group and control group according to fracture classification. 21 unstable fractures were divided into the observation group;20 stable fractures were divided into control group, with closed reduction and PFNA internal fixation treatment, the observation group was treated with extended PFNA internal fixation, and the therapeutic effects of the two groups were observed. Results The operation time, fracture healing time and functional recovery time of the observation group were(72.26±7.06) min,(4.61±0.71) weeks,(5.01±0.81) weeks, and the control group were(55.26±6.28) min,(3.25 ±0.57) weeks,(3.75±0.66) weeks, the time index of the observation group was significantly longer than the control group(t=8.131, 6.742,5.444,P=0.000, 0.000, 0.000), and the intraoperative blood loss was(135.56 ±16.28)mL, significantly more than the control group(112.24±14.48) mL, the difference was statistically significant(t=4.837, P=0.000);the total effective rate of the observation group after treatment was 71.43%, significantly lower than the control group 95.00% The total effective rate( χ^2=4.020, P =0.045);the postoperative follow-up observation group had a complication rate of 28.57%, which was significantly higher than the 5.00% incidence of the control group(χ^2=4.020, P=0.045). Conclusion For the treatment of intertrochanteric fractures, the treatment of long-term PFNA internal fixation has long operation time, more bleeding volume and more postoperative complications. It is often used to treat unstable intertrochanteric fractures. The fracture can be treated with conventional closed reduction PFNA internal fixation.
作者
张兵
ZHANG Bing(Jiangsu RugaoGuangci Hospital,Rugao,Jiangsu Province,226500 China)
出处
《世界复合医学》
2019年第12期32-34,共3页
World Journal of Complex Medicine
关键词
加长型PFNA内固定
闭合复位PFNA内固定
股骨粗隆间骨折
临床疗效
术后并发症
Extended PFNA internal fixation
Closed reduction PFNA internal fixation
Femoral intertrochanteric fracture
Clinical efficacy
Postoperative complications
作者简介
张兵(1976-),男,江苏南通人,本科,副主任医师,研究方向:创伤骨科。
