摘要
[目的]探讨骨水泥强化型股骨近端抗旋转髓内钉(proximal femoral nail antirotation,PFNA)固定骨质疏松性股骨粗隆间骨折的临床效果。[方法]回顾性分析2016年6月—2020年6月手术治疗骨质疏松性股骨粗隆间骨折99例患者的临床资料。依据医患沟通结果,42例采用骨水泥强化型PFNA固定,57例采用人工股骨头置换(hemiarthroplasty,HA)。对比两组患者围手术期、随访和影像资料。[结果]两组患者均顺利完成手术,无严重并发症发生。两组手术时间、切口愈合等级、术后下地时间及住院时间的差异均无统计学意义(P>0.05)。两组患者均获随访,平均随访时间(24.52±8.65)个月。随着时间的推移,两组VAS评分显著下降(P<0.05),而Harris评分、髋伸屈ROM、内-外旋转ROM均显著增加(P<0.05)。相应时间点,两组间VAS评分、Harris评分、髋伸屈ROM、内-外旋转ROM差异均无统计学意义(P>0.05)。两组完全负重活动时间差异无统计学意义(P>0.05)。影像方面,末次随访时,两组股颈干角、股骨头偏距,股骨长度与健侧比较的差异均无统计学意义(P>0.05)。[结论]骨水泥强化型PFNA固定骨质疏松性股骨粗隆间骨折有利于患者早期恢复下地行走和负重活动,临床效果与HA相近。
[Objective]To evaluate the clinical outcomes of bone cement augmented proximal femoral nail anti-rotation(PFNA)for internal fixation of osteoporotic femoral intertrochanteric fractures.[Methods]A retrospective study was conducted on 99 patients who received surgical treatment for osteoporotic femoral intertrochanteric fractures from June 2016 to June 2020.Based on doctor-patient communication,42 patients received cement-augmented PFNA fixation,while the other 57 patients underwent hip hemiarthroplasty(HA).The perioperative,follow-up and imaging data were compared between the two groups.[Results]All the patients in both groups had corresponding surgical procedures performed successfully without serious complications,with no significant differences in terms of operative time,incision healing,postoperative ambulation time and hospital stay between the two groups(P>0.05).As time went during the follow up lasted for(24.52±8.65)months on an average,the VAS score decreased significantly(P<0.05),whereas the Harris score,hip flexion-extension range of motion(ROM),and internal-external rotation ROM significantly increased in both groups(P<0.05).However,there were no significant differences in abovesaid items between the two groups at any matching time points(P>0.05).In addition,there was no a significant difference in the time to resume full-weight bearing activity between the two groups(P>0.05).Radiographically,there were no statistically significant differences in femoral shaft angle,femoral head offset,or femoral length compared with the healthy side between the two groups at the latest follow up(P>0.05).[Conclusion]This cement-augmented PFNA fixation of osteoporotic femoral intertrochanteric fractures is beneficial to the early recovery of walking and weight-bearing activities,and achieves the clinical outcomes similar to the HA.
作者
黄宇
李清龙
莫冰峰
梁斌
林贞桦
尹东
HUANG Yu;LI Qing-long;MO Bing-feng;LIANG Bin;LIN Zhen-hua;YIN Dong(Department of Traumatic Orthopaedic and Microsurgery,People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2022年第16期1445-1450,共6页
Orthopedic Journal of China
基金
广西自治区卫康委自筹课题项目(编号:Z20210371)。
