首页|两种内固定方法治疗老年人股骨粗隆间骨折的效果比较

两种内固定方法治疗老年人股骨粗隆间骨折的效果比较

Clinical efficacy of two different internal fixations in treating femoral intertrochanteric fractures in older adult patients

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目的 比较两种内固定方法治疗老年人股骨粗隆间骨折的临床效果.方法 采用病例对照研究,回顾性分析合肥市第二人民医院2019年1月至2022年1月收治的老年股骨粗隆间骨折患者152例的临床资料,行闭合复位内固定术,根据置入内固定物不同分为两组,其中股骨近端防旋髓内钉(PFNA)76例,为A组,Intertan76例,为B组.分析两组术中出血量、手术时间、术后并发症、骨折愈合时间及髋关节评分.结果 A组出血量[(197.11±37.85)mL 比(226.84±54.17)mL,t=1.62,P<0.001]、手术时间[(71.16±15.64)min 比(78.49±15.88)min,t=1.67,P<0.001 ]均少于或短于 B组;A 组患者骨折愈合时间(13.29±0.94)周,B组骨折愈合时间(13.20±0.64)周,两组差异无统计学意义(t=0.33,P>0.05);A 组术后并发症发生率为 5.26%(4/76),高于 B 组的 1.32%(1/76)(x2=4.04,P=0.048);A组术后1个月、3个月、1年髋关节术后评分分别为(63.13±2.41)分、(73.50±3.99)分、(84.13±7.57)分,B组术后1个月、3个月、1年髋关节术后评分分别为(68.65±2.65)分、(79.07±3.38)分、(89.56±7.71)分,两组差异均有统计学意义(t=1.89、2.48、2.49,均P<0.001).结论 两种内固定方法治疗股骨粗隆间骨折均疗效显著,Intertan钉术后髋关节评分较高,术后并发症少,但手术出血量较多,手术时间较长.
Objective To investigate the clinical efficacy of two different internal fixations in the treatment of femoral intertrochanteric fractures in older adult patients.Methods The clinical data of 152 older adult patients with femoral intertrochanteric fractures who were treated at the Second People's Hospital of Hefei from January 2019 to December 2022 were retrospectively analyzed.All patients underwent closed reduction and internal fixation surgery.They were divided into two groups based on the different types of internal fixations used.Among them,76 patients received internal fixation using proximal femoral intramedullary nails(group A),while 76 patients received internal fixation using Intertan nails(group B).The intraoperative blood loss volume,surgical time,postoperative complications,fracture healing time,and hip joint function score were compared between the two groups.Results The intraoperative blood loss volume in group A was(197.11±37.85)mL,which was significantly less than that in group B[(226.84±54.17)mL,t=1.62,P<0.001].Surgical time in group A was(71.16±15.64)minutes,which was significantly shorter than that in group B[(78.49±15.88)minutes,t=1.67,P<0.001].The fracture healing time in group A was(13.29±0.94)weeks,which was not significantly different from that in group B[(13.20±0.64)weeks,t=0.33,P>0.05].However,the incidence of postoperative complications in group A was 5.26%(4/76),which was significantly higher than 1.32%(1/76)in group B(x2=4.04,P=0.048).At 1 and 3 months and 1 year after surgery,the hip joint function score in group A was(63.13±2.41)points,(73.50±3.99)points,and(84.13±7.57)points,respectively,and it was(68.65±2.65)points,(79.07±3.38)points,and(89.56±7.71)points,respectively,in group B.At the above-mentioned time points,the difference in hip joint function score between the two groups was statistically significant(t=1.89,2.48,2.49,all P<0.001).Conclusion Both internal fixation methods have significant therapeutic effects on femoral intertrochanteric fractures.Internal fixation using Intertan nails leads to higher hip joint function scores and fewer postoperative complications compared with internal fixation using proximal femoral intramedullary nails,but it results in more blood loss and a longer surgical time.

Femoral neck fracturesFracture fixation,internalInternal fixatorsFracture healingOperative time

许飞、方兴

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合肥市第二人民医院骨科,合肥 230011

股骨颈骨折 骨折固定术,内 内固定器 骨折愈合 手术时间

2024

中国基层医药
中华医学会,安徽医科大学

中国基层医药

影响因子:1.003
ISSN:1008-6706
年,卷(期):2024.31(2)
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