Department of Orthopedic, Renmin Hospital of Wuhan University, Wuhan, China.
Eur Rev Med Pharmacol Sci. 2018 Jul;22(1 Suppl):1-7. doi: 10.26355/eurrev_201807_15346.
This study sought to compare the effects of proximal femoral nail anti-rotation (PFNA) and dynamic hip screw (DHS) helical blade treatments in patients with osteoporotic femoral intertrochanteric fractures.
Eighty elderly osteoporosis patients with femoral intertrochanteric fracture complications admitted to the hospital between January 2013 and December 2014 were selected and divided into control (n=40) and observation (n=40) groups. The control group received DHS internal fixation while the observation group received PFNA treatment. Patients were followed up for 18 months, during which pre- and post-operative duration, Harris hip joint function scale, pain, bone mineral density and calcitonin level, 10 meter walking speed, five-fold-sit-to-stand test time, fracture healing and weight bearing time, and related complications were compared between groups.
Operational duration, hemorrhaging and drainage volume were all decreased in the observational group relative to the control group (p<0.05). Pre-operative Harris hip joint function scale scores were not significantly different between the two groups, but were superior in the observation group post-operation (p<0.05). A similar trend was observed for pain degree, bone mineral density and calcitonin levels, 10-meter walking speed, five-fold-sit-to-stand test time, and fracture and weight healing time (p<0.05). Complication incidence, such as coxa vara, loose nail, bone nonunion, delayed union of fracture, femoral head necrosis and deep venous thrombosis, etc., in the observation group was significantly lower than in the control group (p<0.05).
PFNA is characterized by minimal invasiveness, shorter time of operation, and accelerated post-operative recovery during the treatment of osteoporotic intertrochanteric fractures, and effectively improved patient bone density post-operatively, thus further promoting joint function recovery and reducing complication incidence.
本研究旨在比较股骨近端防旋髓内钉（PFNA）和动力髋螺钉（DHS）螺旋刀片治疗骨质疏松性股骨粗隆间骨折的效果。
选取 2013 年 1 月至 2014 年 12 月我院收治的老年骨质疏松性股骨粗隆间骨折并发症患者 80 例，按随机数字表法分为对照组（n=40）和观察组（n=40）。对照组给予 DHS 内固定治疗，观察组给予 PFNA 治疗。患者均随访 18 个月，比较两组患者术前、术后手术时间、Harris 髋关节功能评分、疼痛程度、骨密度和降钙素水平、10 米步行速度、五次坐立时间、骨折愈合及负重时间，以及相关并发症。
观察组患者手术时间、术中出血量及引流量均低于对照组（p<0.05）。两组患者术前 Harris 髋关节功能评分比较差异无统计学意义，观察组术后 Harris 髋关节功能评分优于对照组（p<0.05）。两组患者疼痛程度、骨密度和降钙素水平、10 米步行速度、五次坐立时间、骨折愈合及负重时间比较差异均有统计学意义（p<0.05）。观察组患者并发症发生率（如髋内翻、钉松动、骨不愈合、骨折延迟愈合、股骨头坏死、深静脉血栓形成等）明显低于对照组（p<0.05）。
PFNA 治疗骨质疏松性股骨粗隆间骨折具有微创、手术时间短、术后恢复快等特点，能有效提高患者术后骨密度，进一步促进关节功能恢复，降低并发症发生率。
