| 赵纬.股骨近端锁定钢板和股骨近端内固定系统治疗老年骨质疏松性粗隆间骨折的临床疗效对比[J].浙江中西医结合杂志,2020,30(4): |
| 股骨近端锁定钢板和股骨近端内固定系统治疗老年骨质疏松性粗隆间骨折的临床疗效对比 |
| Comparison of clinical efficacy of proximal femoral locking plate and proximal femoral nail antirotation system in the treatment of eldery osteoporotic intertrochanteric fractures |
| 投稿时间：2019-05-31 修订日期：2020-02-22 |
| DOI： |
| 中文关键词: 骨质疏松性粗隆间骨折 老年 股骨近端锁定钢板 股骨近端内固定系统 疗效 |
| 英文关键词:osteoporotic intertrochanteric fracture eldery proximal femoral locking plate proximal femoral nail antirotation curative effect |
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| 中文摘要: |
| 目的 比较股骨近端锁定钢板和股骨近端内固定系统治疗老年骨质疏松性粗隆间骨折(OIF)的临床疗效。方法 选取2017年9月至2018年12月本院骨科收治的65例老年OIF患者,分为对照组(32例)采取股骨近端锁定钢板治疗,观察组(33例)采取股骨近端内固定系统治疗。比较两组患者术中出血量、手术时间、术后引流量、骨密度变化、Harris评分、骨折愈合率及术后并发症发生情况等差异。结果 相比对照组,观察组术中出血量明显增多,手术时间明显延长(P<0.01)；而两组患者术后引流量和功能锻炼时间的比较,并无明显差异(P>0.05)。相比术前,两组患者术后骨密度均显著改善(P<0.01),两组患者术前、术后骨密度的组间比较,并无明显差异(P>0.05)。观察组术后3、6个月骨折愈合率较对照组显著升高(P<0.05),两组患者术后12个月骨折愈合率和Harris评分比较,并无明显差异(P>0.05)。两组患者术后并发症发生率比较,并无明显差异(P>0.05)。结论 相比股骨近端锁定钢板,老年OIF患者应用股骨近端内固定系统治疗可促进早期骨性愈合,提高内固定的稳定性,但手术时间较长,术中出血量较多,因此临床中应根据具体情况选择合适的术式以更好地提升患者的治疗效果。 |
| 英文摘要: |
| To compare the clinical efficacy of proximal femoral locking plate and proximal femoral internal fixation system in the treatment of eldery osteoporotic intertrochanteric fractures (OIF). Methods 65 elderly OIF patients admitted to the department of orthopedics of our hospital from September 2017 to December 2018 were selected and divided into the control group (32 cases) receiving proximal femoral locking plate treatment, and the observation group (33 cases) receiving proximal femoral nail antirotation system treatment. Intraoperative blood loss, operative time, postoperative drainage volume, changes in bone density, Harris score, fracture healing rate and postoperative complications were compared between the two groups. Results Compared with the control group, the amount of intraoperative bleeding in the observation group was significantly increased, and the operation time was significantly prolonged (P<0.01). However, there was no significant difference in postoperative drainage volume and functional exercise time between the two groups (P>0.05). Compared with preoperative, postoperative bone mineral density of the two groups was significantly improved (P<0.01), and there was no significant difference between the two groups in preoperative and postoperative bone mineral density (P>0.05). Fracture healing rate in the observation group was significantly higher than that in the control group at 3 and 6 months after surgery (P<0.05), and there was no significant difference between the two groups in fracture healing rate and Harris score at 12 months after surgery (P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion Compared with proximal femoral locking plate, the application of proximal femoral nail antirotation system in elderly OIF patients can promote early bone healing and improve the stability of internal fixation, but the operation time is long and the amount of intraoperative blood loss is large. Therefore, appropriate surgical methods should be selected according to the specific situation in clinical practice to better improve the treatment effect. |
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