经皮防旋股骨近端髓内钉内固定对老年股骨粗隆间骨折患者髋关节功能、生活质量的影响

Effect of percutaneous anti-rotation of the proximal femoral nail internal fixation on hip joint function and quality of life in elderly patients with intertrochanteric fracture

  • 摘要:
      目的  探讨经皮防旋股骨近端髓内钉(PFNA)内固定治疗对老年股骨粗隆间骨折患者髋关节功能恢复情况和生活质量的影响。
      方法  将92例老年股骨粗隆间骨折患者纳入研究,按不同手术方式分为2组,对照组46例患者采用动力髋螺钉(DHS)内固定治疗,试验组46例患者采用经皮防旋股骨近端髓内钉(PFNA)内固定治疗,对比2组患者的髋关节功能优良率、手术指标。随访3个月,对比2组治疗前、治疗3个月后的生活质量评分。
      结果  试验组的髋关节功能优良率(95.65%)高于对照组(69.57%), 手术时间、下床活动时间、住院时间短于对照组,切口长度短于对照组,治疗3个月后的生活质量评分高于对照组,差异均有统计学意义(P<0.05)。
      结论  老年股骨粗隆间骨折患者应用经皮PFNA内固定术治疗,髋关节功能优良率较高,术后可尽早下床活动,生活质量及预后良好。

     

    Abstract:
      Objective  To analyze effect of percutaneous anti-rotation of the proximal femoral nail(PFNA) internal fixation on hip joint function and quality of life in elderly patients with intertrochanteric fracture.
      Methods  A total of 92 patients with femoral intertrochanteric fracture admitted to our hospital were enrolled in the study, and were divided into two groups by different surgeries. The patients in the control group(n=46) were treated with internal fixation of dynamic hip screw (DHS), and those in the experimental group(n=46) were treated with percutaneous PFNA. The excellent rate of hip function and surgical index were compared between the two groups. Quality scores of two groups before and after 3-month treatment during 3-month follow-up was compared.
      Results  The excellent rate of hip function in the experimental group was significantly higher than that in the control group (95.65% vs. 69.57%, P<0.05). The operation, the time of bed-off, the length of hospital stay and the length of the incision were significantly shorter in the experimental group than in the control group(P<0.05). The quality of life score of the experimental group after 3 months of treatment were significantly higher than that in the control group(P<0.05).
      Conclusion  Percutaneous PFNA internal fixation has higher excellent rate, can promote the early postoperative bed-off activity, and improve quality of life and prognosis for elderly patients with femoral intertrochanteric fractures.

     

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