股骨粗隆间骨折手术髓内固定和髓外固定治疗临床对比.docVIP

股骨粗隆间骨折手术髓内固定和髓外固定治疗临床对比 　　【摘 要】目的：对比髓外固定和髓内固定两种手术方式治疗股骨粗隆间骨折的效果。方法：选择股骨粗隆间骨折患者74例，随机分成对照组和治疗组，每组37例。对照组实施动力髋螺钉髓外固定手术；治疗组实施股骨近端髓内钉内固定手术。结果：治疗组患者髋关节功能Harris评分和疼痛程度VAS评分在手术前后的改善幅度大于对照组（P0.05）；骨折手术治疗总及格率为91.9%，对照组仅70.3%（P0.05）；术后并发症仅有1例，对照组有6例（P0.05）；手术操作时间、负重运动时间、住院总时间、髋关节功能恢复时间短于对照组（P0.05）。结论：股骨近端髓内钉内固定手术治疗股骨粗隆间骨折，与髓外固定比较，能够更大幅度改善髋关节功能，减轻疼痛，减少术后并发症，缩短疾病治疗时间，保证治疗效果。 　　【关键词】股骨近端髓内钉内固定；动力髋螺钉髓外固定；股骨粗隆间骨折；手术 　　Abstract Objective： To compare the effect of two methods of external fixation and intramedullary fixation in the treatment of intertrochanteric fracture of the femur. Methods： 74 cases of intertrochanteric fracture of the femur were selected and divided into the control group and the treatment group randomly， with 37 cases in each group. The control group was operated on the dynamic hip screw extramedullary fixation， and the treatment group performed the intramedullary nail fixation of the proximal femur. Results： the treatment group of patients with Harris hip score and pain VAS scores before and after surgery improved more significantly than that of control group （P 0.05）； surgical treatment of fracture of the total pass rate of 91.9%， while the control group was only 70.3% （P 0.05）； only 1 cases of postoperative complications， 6 cases in the control group （P 0.05）； operation time， hospitalization time， weight-bearing exercise time， hip function recovery time was shorter than the control group （P 0.05）. Conclusion： proximal femoral intramedullary nailing for intertrochanteric fractures is better than extramedullary fixation in the treatment of femoral intertrochanteric fractures， which can significantly improve the function of hip joint， reduce pain， reduce postoperative complications， shorten the time of disease treatment， and ensure the treatment effect. 　　Key words： internal fixation of proximal femoral nail； extramedullary fixation of dynamic hip screw； intertrochanteric fracture of femur； operation 　　【中图分类号】R683.42 【文献标识码】B 【文章编号】1672-3783（2018）01-0