老年骨质疏松性髋部骨折PFN内固定临床疗效(1)

http://www.100md.com 2017年3月5日 《医学信息》 2017年第9期

     摘要：目的 观察并讨论老年骨质疏松性髋部骨折患者应用PFN内固定的临床疗效及注意事项。方法 选取2013年6月～2015年6月来本院治疗的110例老年骨质疏松性髋部骨折患者展开回顾性分析，关节置换组48例，内固定组62例。TER 28例、半髋置换20例；髓外固定22例、PFN内固定40例；比较患者围手术期的术中出血量、手术时间、下地时间、术后引流量及髋关节功能恢复情况。结果 PEN内固定术的术中出血量和术后引流量明显少于TER组、半髋置换组、髓外固定组(P<0.05)，PFN内固定组下地时间明显少于髓外固定组存在明显差异(P<0.05)，PFN内固定组住院时间与TER组、半髋置换组、髓外固定组无明显差异(P>0.05)。结论 PFN内固定术髓内有可靠的支撑装置，能够承担患者的较大重力，较之髓外固定术能够使患者更早下地，降低患者无法下地活动所可能引发的并发症，如患者不耐受大手术建议实施近端髓内钉。

    关键词：PFN内固定术；髋部骨折；骨质疏松；临床疗效

    Clinical Study of PFN Internal Fixation in the Treatment of Osteoporotic Hip Fracture in Elderly Patients
, 百拇医药
    WANG Yun-hua

    (Department of Orthopedics，Second People's Hospital of Kunming，Kunming 650204，Yunnan，China)

    Abstract：Objective To observe and discuss the osteoporotic hip fracture in the elderly patients with clinical application of PFN internal fixation and precautions.Methods From June 2013 to June 2015 in our hospital treatment of 110 cases of osteoporotic hip fracture in elderly patients were retrospectively analyzed，48 cases of hip arthroplasty group，62 patients in the internal fixation group.TER 28 cases，20 cases of half hip replacement； extramedullary fixation in 22 cases，PFN internal fixation in 40 cases；the amount of bleeding，compared with perioperative operation time，ambulation time，postoperative drainage and functional recovery of the hip joint.Results The intraoperative blood loss and postoperative drainage volume of PEN internal fixation were significantly lower than those of TER group，hemiarthroplasty group and extramedullary fixation group(P<0.05).The time of PFN fixation was significantly less than that of extramedullary fixation(P<0.05).There was no significant difference between PFN internal fixation group and TER group，hemi-hip replacement group and extramedullary fixation group (P>0.05).Conclusion PFN internal fixation has a reliable supporting device in the intramedullary muscle，which can bear the greater gravity of the patient than the extramedullary fixation can make the patient earlier and reduce the complications that the patient can not cause under the ground，such as the patient intolerance proposed proximal intramedullary nail during major surgery.
, 百拇医药
    Key words：PFN internal fixation；Hip fracture；Osteoporosis；Clinical efficacy

    隨着年龄的增长，身体各机能皆出现不可逆下降，疾病发生率也会进一步升高，而这些因素均和髋部骨折有显著关联[1]。如脑血管后遗症等疾病会致使患者肢体功能发生障碍，关节变形，活动受限，易摔倒，更因体力活动量小，导致了骨质疏松[2]。髋部骨折类型有许多种，老年患者中多合并骨质疏松，即使遭遇低能量损伤也可能产生骨折，且为粉碎性，加之患者多合并内科疾病，进而给临床治疗增加了困难，如复位难，固定牢固，因患者自身体质差影响骨折愈合效果，对患者生活质量造成不利影响[3]。本院对应用PFN内固定术治疗老年骨质疏松性髋部骨折患者活动功能的临床效果进行评估和探讨，收获了良好的效果，现报道如下。, http://www.100md.com(王云华)

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