青岛大学学报（医学版）2025，Vol.61Issue(5)：699-704,6.DOI:10.11712/jms.2096-5532.2025.61.163
PFNA治疗老年股骨转子间不稳定骨折效果及对髋关节功能影响
Therapeutic effect of proximal femoral nail antirotation for unstable intertrochanteric fractures in elderly patients and its impact on hip joint function
摘要
Abstract
Objective To investigate the efficacy of proximal femoral nail antirotation(PFNA)in treating unstable intertro-chanteric fractures in elderly patients and its impact on hip joint function.Methods Using a random number table,we assigned 106 elderly patients with unstable intertrochanteric fractures admitted to our hospital from January 2020 to December 2022 to re-ceive either fixation with proximal femur locking plates(control group)or PFNA(study group),with 53 cases in each group.The two groups were compared in terms of surgery-related indexes,hip joint function,imaging features,and coagulation parameters before and after surgery,and postoperative complications.Results Compared with the control group,the study group showed significantly shorter incision length,operation time,postoperative weight-bearing time,length of hospital stay,and fracture hea-ling time and significantly reduced bleeding loss and drainage volume during operation(t=-13.790--2.670,P＜0.05).With the extension of follow-up time after surgery,the Harris scores increased significantly in both groups(F=351.596,304.214,P＜0.05);the Harris scores of the study group were significantly higher than those of the control group at 3,6,and 12 months after surgery(F=3.423-5.466,P＜0.05).Compared with the control group,the study group had a significantly larger neck-shaft angle and a significantly smaller tip-apex distance at 12 months after surgery as well as significantly smaller differences in the two para-meters before and after surgery(t=3.279-6.693,P＜0.05).Compared with the control group,the study group had significantly longer thrombin time,prothrombin time,and activated partial thromboplastin time and a significantly lower D-dimer level at 12 months after surgery,as well as significantly smaller differences in these indicators before and after surgery(t=2.655-7.139,P＜0.05).The incidence of postoperative complications was significantly lower in the study group than in the control group(x2=9.396,P＜0.05).Conclusion For unstable intertrochanteric fractures in elderly patients,PFNA can fasten hip joint function re-covery,reduce changes in the tip-apex distance and neck-shaft angle,alleviate the impact on coagulation function,reduce the incidence of complications,and promote the recovery of patients.关键词
股骨转子间骨折/股骨近端防旋髓内钉/老年人/髋关节/治疗结果Key words
femoral intertrochanteric fractures/proximal femoral nail anti-rotation/aged/hip joint/treatment outcome分类
医药卫生引用本文复制引用
苗陆,徐兵,田俊华..PFNA治疗老年股骨转子间不稳定骨折效果及对髋关节功能影响[J].青岛大学学报（医学版）,2025,61(5):699-704,6.基金项目
河南省医学科技攻关计划项目(LHGJ202-10148) （LHGJ202-10148）
