摘要
目的分析有限切开钛缆捆扎辅助股骨近端髓内钉(PFNA)固定治疗老年骨质疏松性31-A3型股骨粗隆间骨折(IFF)患者的效果。方法选取焦作煤业(集团)有限责任公司中央医院2018年1月至2020年6月收治的91例老年骨质疏松性31-A3型IFF患者作为研究对象,依照手术方案分为两组,对照组(45例)接受骨拨或复位钳辅助PFNA固定治疗,观察组(46例)接受有限切开钛缆捆扎辅助PFNA固定治疗,比较两组手术及术后情况(手术时间、术中失血量、骨折愈合时间);记录术前和术后6个月髋关节功能[Harris髋关节功能评分量表(Harris评分)];记录两组计时起立行走测试(TUG)和并发症;比较两组术前和术后1个月骨代谢水平[骨钙素(OC)、骨型碱性磷酸酶(BALP)、总Ⅰ型胶原氨基端延长肽(tPINP)、Ⅰ型胶原羧基末端肽(sCTx)]。结果观察组手术时间较对照组短,术中失血量较对照组少(P<0.05);两组骨折愈合时间比较,差异无统计学意义(P>0.05)。术后6个月,两组髋关节功能均得到改善(P<0.05);两组Harris评分比较,差异无统计学意义(P>0.05);术后6个月,两组TUG均得到改善,且观察组短于对照组(P<0.05);与对照组(33.33%)对比,观察组并发症发生率(13.04%)较低(P<0.05);术后1个月,两组骨代谢水平均有所改善,且观察组血清OC、BALP、tPINP较对照组高,sCTx较对照组低(P<0.05)。结论有限切开钛缆捆扎辅助PFNA固定治疗老年骨质疏松性31-A3型IFF患者,能缩短手术时间,减少术中失血量,调节骨代谢水平,改善髋关节功能,减少并发症。
Objective To analyze the curative effect of limited incision titanium cable tying assisted proximal femoral nail antirotation(PFNA)fixation in the treatment of elderly osteoporotic 31-A3 intertrochanteric fracture of femur(IFF).Methods A total of 91 patients with osteoporotic 31-A3 IFF in Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.from January 2018 to June 2020 were selected as the research objects.They were divided into two groups according to surgical plans.The control group(45 cases)received bone allotment or reduction forceps assisted PFNA fixation treatment.The observation group(46 cases)received limited incision titanium cable strapping assisted PFNA fixation treatment.The operation and postoperative conditions(operation time,intraoperative blood loss,fracture healing time)were compared between the two groups.Hip joint function[Harris hip function score scale(Harris Score)]was recorded preoperation 6 months postoperative.Timed up and go test(TUG)and complications were compared between the two groups.Bone metabolism levels[osteocalcin(OC),bone alkaline phosphatase(BALP),total procollagen typeⅠamino-terminal propeptide(tPINP),C-terminal telopeptide of typeⅠcollagen(sCTx)]were compared between the two groups before and 1 month after surgery.Results The operation time of the observation group was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).There was no statistical difference in fracture healing time between the two groups(P>0.05).At 6 months after operation,the hip joint function of the two groups were improved(P<0.05),but there was no statistical difference in Harris scores between the two groups(P>0.05).Six months after the operation,the TUG of the two groups were improved,and the observation group was shorter than the control group(P<0.05).Compared with the control group(33.33%),the observation group had a lower complication rate(13.04%)(P<0.05).Conclusion Limited incision and tying of titanium cables and PFNA fixat
作者
赵东华
杜云峰
王红星
杨小超
梁峰
吴卫宾
ZHAO Donghua;DU Yunfeng;WANG Hongxing;YANG Xiaochao;LIANG Feng;WU Weibin(Department of Orthopaedic Medicine,Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.,Jiaozuo 454000,China)
出处
《河南医学研究》
CAS
2022年第11期2005-2008,共4页
Henan Medical Research
关键词
有限切开钛缆捆扎
股骨近端髓内钉固定
骨质疏松
31-A3型
股骨粗隆间骨折
limited incision titanium cable tying
proximal femoral nail antirotation fixation
osteoporosis
type 31-A3
intertrochanteric fracture of femur
