动力髋和防旋髓内钉内固定对老年股骨转子间骨折患者髋关节功能的影响

摘要/Abstract

摘要： 目的探讨与分析动力髋和防旋髓内钉内固定治疗老年性股骨转子间骨折对髋关节功能恢复的影响。方法选择2019年8月—2022年12月在韩城交大医院骨科进行诊治的97例老年性股骨转子间骨折患者作为研究对象,根据随机数表法将所有患者分为髓内钉组（49例）与对照组（48例）。对照组给予动力髋螺钉内固定手术治疗,髓内钉组给予股骨近端防旋髓内钉内固定手术治疗,记录与观察髓内钉组与对照组的髋关节功能恢复情况。结果所有患者都顺利完成手术,髓内钉组的术后骨痂出现时间、术后骨折愈合时间、术后住院时间、手术时间、术中出血量、术后首次下地活动时间都明显小于对照组,差异有统计学意义（P<0.05）。髓内钉组术后6个月的髋内翻、感染、假体松动、静脉血栓、患肢短缩等并发症发生率低于对照组,差异有统计学意义（P<0.05）。两组术后6个月Harris评分显著高于术前1 d,且髓内钉组术后6个月Harris评分高于对照组,差异有统计学意义（P<0.05）。髓内钉组术后6个月的髋关节功能优良率显著高于对照组,差异有统计学意义（P<0.05）。结论股骨近端防旋髓内钉治疗老年性股骨转子间骨折能促进患者康复,减少对患者的创伤,降低术后并发症的发生率,还可提高髋关节功能Harris评分,改善患者的总体预后疗效。

关键词: 股骨近端防旋髓内钉, 股骨转子间骨折, 并发症, 髋关节功能, Harris评分

Abstract: Objective To explore and analysis the effects of dynamic hip and anti rotation intramedullary nail fixation on hip joint function in elderly patients with intertrochanteric fractures of the femur. Methods From August 2019 to December 2022, 97 cases of elderly patients with intertrochanteric fractures of the femur who underwent treatment at Hancheng Jiaoda Hospital were selected as the research subjects. Accorded to the random number table method, the 97 patients were divided into the intramedullary nail group of 49 cases and the control group of 48 cases. The control group were received dynamic hip screw internal fixation surgery, while the intramedullary nail group were received anti rotation intramedullary nail fixation internal fixation surgery.The recovery of hip joint function in both groups was recorded and observed. Results All patients were successfully completed the surgery, and the time of postoperative callus appearance, postoperative fracture healing time, postoperative hospitalization time, surgical time, intraoperative bleeding volume,and first postoperative movement time in the intramedullary nail group were significantly shorter than those in the control group (P<0.05). The incidence of complications such as hip varus, infection, prosthesis loosening, venous thrombosis, and limb shortening 6 months after surgery in the intramedullary nail group was 6.12%, compared to 22.92% in the control group. The incidence of complications in the intramedullary nail group were significantly lower than that in the control group (P<0.05). The Harris score at 6 months after surgery in both groups was significantly higher than that on the 1st day before surgery (P<0.05), and the Harris score at 6 months after surgery in the intramedullary nail group was also significantly higher than that in the control group (P<0.05). The excellent and good rate of hip joint function in the intramedullary nail group at 6 months after surgery was 97.96%, which was significantly improved compared to 83.33% in the control group (P<0.05). Conclusion The treatment of elderly intertrochanteric fractures with proximal femoral interlocking intramedullary nails can promote patient recovery, reduce trauma to patients, reduce the incidence of postoperative complications, and improve the Harris score of hip joint function, thereby improving the overall prognosis and efficacy of patients.

Key words: proximal femur, intertrochanteric fracture, complications, hip function, Harris grade

中图分类号:

R687.3

徐辉, 张银刚. 动力髋和防旋髓内钉内固定对老年股骨转子间骨折患者髋关节功能的影响[J]. 中华养生保健, 2024, 42(11): 43-46.

XU Hui, ZHANG Yin-gang. The Effect of Dynamic Hip and Antirotation Intramedullary Nail Fixation on Hip Joint Function in Elderly Patients with Intertrochanteric Fractures of the Femur[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(11): 43-46.

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