股骨前弓角应用在PFNA治疗股骨粗隆间骨折中临床价值.docVIP

股骨前弓角应用在PFNA治疗股骨粗隆间骨折中临床价值 　　[摘要] 目的 探讨股骨前弓角用于抗旋型股骨近端髓内钉（Proximal femoral nail antirontation ，PFNA）治疗股骨粗隆间骨折中的临床价值。 方法 选取我院2014年1月～2016年12月收治的行股骨粗隆间骨折手术的患者90例，常规手术治疗患者50例（对照组），术前测量股骨前弓角指导手术治疗患者40例（观察组），观察、分析手术患者的治疗情况。结果 对照组平均出血量为（150.8±32.4）mL，观察组平均出血量为（138.5±39.8）mL，比较差异无统计学意义（t=1.6165，P0.05）。随访6～24个月，平均14个月；全部患者均骨性愈合，愈合时间3～5个月，平均时间（3.9±0.6）个月。对照组髋关节功能的优良率为80.0%，观察组髋关节功能的优良率为95.0%，两组比较差异具有统计学意义（P0.05）。 结论 术前测量股骨前弓角，选择适合的髓内钉假体进行PFNA治疗，可有效改善股骨粗隆间骨折患者的髋关节功能及临床疗效。因此，在股骨粗隆间骨折患者PFNA治疗的过程中，术前测量股骨前弓角具有重要的临床价值。 　　[关键词] 股骨前弓角；PFNA；股骨粗隆间骨折；内固定 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2017）30-0064-04 　　[Abstract] Objective To explore the clinical value of femoral anterior arch angle in the treatment of femoral intertrochanteric fractures with proximal femoral nail antiretation （PFNA）. Methods A total of 90 patients with femoral intertrochanteric fractures admitted in our hospital from January 2014 to December 2016 were divided into control group （n=50） with conventional surgical treatment and observation group （n=40） with preoperative measurement of femoral anterior arch angle for guiding surgical treatment of patients. The surgical treatment of patients was observed and analyzed. Results The average blood loss was （150.8±32.4）mL in the control group， and the average blood loss was （138.5±39.8） mL in the observation group， and there was no significant difference between the two groups（t=1.6165， P0.05）. The patients were followed up for 6-24 months， with an average of 14 months. All patients were bone healed， and the healing time was 3-5 months， with the average time of（3.9±0.6） months. The excellent rate of hip function was 80.0% in the control group. The excellent rate of hip function was 95.0% in the observation group， and the difference was statistically significant（P0.05）. Conclusion Preoperative measurement of femoral anterior arch angle and selection of suitable intramedullary nail prosthesis for PFNA can effectively improve the function of hip joint and clinical