经PFNA切开与闭合复位治疗老年难复性股骨粗隆间骨折的效果比较(1)
摘要：目的 分析PFNA治療老年难复性股骨粗隆间骨折的闭合复位策略，并评价其疗效。方法 选择2014年1月～2020年1月我院应用防旋型股骨近端髓内钉治疗的难复性老年股骨粗隆间骨折患者50例作为研究对象，随机分为实验组与对照组，各25例。对照组采用切开复位治疗，实验组根据骨折移位机制采用闭合复位治疗;比较两组手术时间、术中出血量、透视次数、术后感染率及骨折延迟愈合率，术后6个月随访髋关节Harris评分。结果 实验组手术时间、术中出血量、术后感染率、骨折延迟愈合率均少于对照组，差异有统计学意义(P<0.05);两组术中透视次数、术后6个月髋关节Harris评分比较，差异无统计学意义(P>0.05)。结论 PFNA术前充分认识难复性股骨粗隆间骨折分型、移位机制，术中借助各种方法闭合复位治疗老年难复性股骨粗隆间骨折能够取得较好的疗效，手术时间短、术中出血量少，患者术后感染及骨折延迟愈合较少发生。
关键词：难复性股骨粗隆间骨折;股骨近端抗旋髄内钉;闭合复位
中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.21.035
文章编号：1006-1959(2020)21-0114-04
Abstract：Objective To analyze the closed reduction strategy of PFNA in the treatment of refractory femoral intertrochanteric fractures in the elderly， and evaluate its efficacy.Methods From January 2014 to January 2020， 50 elderly patients with refractory intertrochanteric femoral fractures treated with anti-rotation proximal femoral nails were selected as the research objects. They were randomly divided into experimental group and control group. 25 cases each. The control group was treated with open reduction， and the experimental group was treated with closed reduction according to the mechanism of fracture displacement; the operation time， intraoperative blood loss， number of fluoroscopy， postoperative infection rate， and delayed fracture healing rate were compared between the two groups. Follow-up 6 months after surgery Harris score of the hip joint.Results The operation time， intraoperative blood loss， postoperative infection rate， and delayed fracture healing rate of the experimental group were lower than those of the control group，the difference was statistically significant (P<0.05); the number of intraoperative fluoroscopy and hip joints at 6 months postoperatively compared with Harris score， the difference was not statistically significant (P>0.05).Conclusion Before PFNA operation， we fully understood the classification and displacement mechanism of refractory femoral intertrochanteric fractures. During the operation， various methods could be used to close reduction in the treatment of elderly refractory femoral intertrochanteric fractures. It could achieve better curative effect， and the operation time was short. Intraoperative blood loss was small， and postoperative infections and delayed fracture healing were rare., 百拇医药(朱小建 曹建华 陶永清)
关键词：难复性股骨粗隆间骨折;股骨近端抗旋髄内钉;闭合复位
中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.21.035
文章编号：1006-1959(2020)21-0114-04
Abstract：Objective To analyze the closed reduction strategy of PFNA in the treatment of refractory femoral intertrochanteric fractures in the elderly， and evaluate its efficacy.Methods From January 2014 to January 2020， 50 elderly patients with refractory intertrochanteric femoral fractures treated with anti-rotation proximal femoral nails were selected as the research objects. They were randomly divided into experimental group and control group. 25 cases each. The control group was treated with open reduction， and the experimental group was treated with closed reduction according to the mechanism of fracture displacement; the operation time， intraoperative blood loss， number of fluoroscopy， postoperative infection rate， and delayed fracture healing rate were compared between the two groups. Follow-up 6 months after surgery Harris score of the hip joint.Results The operation time， intraoperative blood loss， postoperative infection rate， and delayed fracture healing rate of the experimental group were lower than those of the control group，the difference was statistically significant (P<0.05); the number of intraoperative fluoroscopy and hip joints at 6 months postoperatively compared with Harris score， the difference was not statistically significant (P>0.05).Conclusion Before PFNA operation， we fully understood the classification and displacement mechanism of refractory femoral intertrochanteric fractures. During the operation， various methods could be used to close reduction in the treatment of elderly refractory femoral intertrochanteric fractures. It could achieve better curative effect， and the operation time was short. Intraoperative blood loss was small， and postoperative infections and delayed fracture healing were rare., 百拇医药(朱小建 曹建华 陶永清)