摘要
目的探究股骨近端髓内钉(PFNA)固定术与髋关节置换术对高龄股骨粗隆间骨折患者的应用。方法选择2020年1月至2023年1月于南昌大学附属三三四医院骨科就诊的72例高龄股骨粗隆间骨折患者为研究对象,通过区组随机化法随机分为观察组及对照组,每组各36例。观察组采用PFNA固定术,对照组采用髋关节置换术。比较两组患者围手术期相关指标,于术前及术后6个月比较两组髋关节功能评分(Harris)、独立功能评分(FIM),于术后6个月比较其并发症发生情况。结果两组患者住院时间、并发症发生情况比较,差异无统计学意义(P>0.05)。观察组手术时间、骨折愈合时间短于同期对照组,下地负重时间长于对照组,差异有统计学意义(P<0.05)。术后6个月,观察组Harris评分、FIM评分均高于对照组,差异有统计学意义(P<0.05)。结论PFNA固定术相较于髋关节置换术对高龄股骨粗隆间骨折患者具有更优异的应用效果,能够促进其骨折愈合,改善其髋关节功能,增强其独立生活能力。
Objective To explore the application of proximal femoral nail anti-rotation(PFNA)fixation and hip replacement in elderly patients with femoral intertrochanteric fractures.Methods From January 2020 to January 2023,72 elderly patients with femoral intertrochanteric fractures in the 334 Affiliated Hospital of Nanchang University were selected as the study subjects,and were randomly divided into observation group and control group by means of block randomization method,with 36 cases in each group.PFNA fixation was performed in observation group,and hip replacement was performed in control group.The perioperative related indicators,hip function score(Harris)and functional independent measure(FIM)before surgery and at 6 months after surgery and occurrence of complications at 6 months after surgery were compared.Results There were no significant differences in hospital stay and complications between the two groups(P>0.05).The operation time and fracture healing time of the observation group were shorter than those of the control group,and the weight-bearing time was longer than that of the control group,the differences were statistically significant(P<0.05).Six months after operation,the Harris score and FIM score of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with hip replacement,PFNA fixation has a better application effect on elderly patients with femoral intertrochanteric fractures,and it can promote fracture healing,improve hip function and enhance independent living ability.
作者
肖立平
李志
邵培
XIAO Liping;LI Zhi;SHAO Pei(Department of Orthopedics,the 334 AffiliatedHospital of Nanchang University,Jiangxi Province,Nanchang 330000,China)
出处
《中国当代医药》
2025年第3期69-72,共4页
China Modern Medicine
基金
江西省卫生计生委科技计划项目(20194014)。
关键词
股骨粗隆间骨折
股骨近端髓内钉固定术
髋关节置换术
高龄患者
并发症
Femoral intertrochanteric fractures
Proximal femoral nail anti-rotation fixation
Hip replacement
Elderly patients
Complication
