摘要
目的:探讨股骨近端放旋髓内钉(PFNA)与股骨头置换治疗老年骨质疏松股骨粗隆间骨折(IFF)的效果。方法:回顾性分析2016年1月~2017年8月在我院接受治疗的97例老年骨质疏松IFF患者的临床资料,根据治疗方式的不同分为PFNA组(n=57)与置换组(n=40)。比较两组患者围手术情况和术后并发症。术后1、3、6、12个月,采用Harris髋关节功能量表评估两组患者髋关节功能,采用日常生活能力量表(ADL)评估两组患者日常生活能力。结果:与置换组比较,PFNA组手术切口长度、手术时间、术中出血量明显减少,术后疼痛VAS评分明显减轻,下地负重时间明显延长,术后并发症总发生率明显降低。术后1、3个月,置换组髋关节功能和日常生活能力均优于PFNA组;术后6、12个月,两组髋关节功能和日常生活能力比较差异无统计学意义。结论:PFNA与股骨头置换均能够有效重建老年骨质疏松IFF患者的髋关节功能。PFNA具有创伤小、并发症少、术后疼痛轻等优势,而股骨头置换能够及早重建髋关节功能和提高日常生活能力。应严格把握手术适应证,综合各方面因素,选择最恰当的术式。
Objective To investigate the effect of proximal femoral nail(PFNA)and femoral head replacement in the treatment of osteoporosis-related intertrochanter fracture of femur of the elderly.Methods Clinical data of 97 elderly patients with osteoporosis-related IFF treated in our hospital from January 2016 to August 2017 were retrospectively analyzed.All patients were divided into PFNA group(n=57)and replacement group(n=40),according to the different treatment.Perioperative conditions and postoperative complications were compared between the two groups.At 1,3,6,and 12 months after surgery,the hip joint function of the two groups was assessed with Harris Hip Function Scale,and the ability of daily living(ADL)of the two groups was assessed.Results Compared with the replacement group,the incision length,operation time and bleeding volume of PFNA group were significantly reduced,the VAS score of pain was significantly reduced,the load-bearing time was significantly prolonged,and the total incidence of postoperative complications was significantly reduced.At 1 and 3 months after surgery,the hip joint function and daily living ability of the replacement group were better than those of the PFNA group.At 6 and 12 months after surgery,there was no significant difference in hip joint function and daily living ability between the two groups.Conclusion PFNA and femoral head replacement can effectively reconstruct hip joint function in elderly patients with osteoporosis-related IFF.PFNA has the advantages of less trauma,fewer complications and less postoperative pain.Femoral head replacement can reconstruct hip joint function and improve daily living ability as early as possible.We should strictly grasp the indications of operation and combine various factors to select the most appropriate surgical procedure.
作者
蔡筱松
刘恒
周敏
张倩
刘宏滨
Cai Xiao-song;Liu Heng;Zhou Min;Zhang Qian;Liu Hong-bin(Department of Orthopedics,71st Group Army Hospital,Chinese people’s Liberation Army,Xuzhou 221000,China)
出处
《湖南师范大学学报（医学版）》
2020年第3期136-139,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
股骨近端放旋髓内钉
股骨头置换
骨质疏松股骨粗隆间骨折
proximal femoral nail
femoral head replacement
osteoporosis-related intertrochanter fracture of femur
