股骨近端防旋髓内钉与股骨头置换术治疗不稳定型股骨转子间骨折疗效分析

Analysis of Therapeutic Effect of Proximal Femoral Nail Antirotation and Femoral Head Replacement for Unstable Intertrochanteric Fracture

摘要: 目的：回顾性分析股骨近端防旋髓内钉与股骨头置换术治疗不稳定型股骨转子间骨折的临床效果。方法：回顾性分析2017年1月~2022年1月宜昌市第一人民医院收治的123例不稳定型股骨转子间骨折的临床资料。按照术式，将80例患者纳入股骨近端防旋髓内钉组，将43例患者纳入股骨头置换组，比较两组的疼痛情况，髋关节功能，并发症等情况。结果：随访大于3个月后，股骨近端防旋髓内钉组髋关节功能Harris评分的优良率高于股骨头置换组，两组比较具有统计学意义(P < 0.05)；股骨近端防旋髓内钉组术后并发症发生情况低于股骨头置换组，两组比较具有统计学意义(P < 0.05)。结论：股骨近端防旋髓内钉治疗不稳定型股骨转子间骨折时，具有更高的髋关节功能Harris评分，髋功能恢复好，疼痛改善，并发症少。股骨头置换治疗不稳定型股骨转子间骨折时，并发症多，临床医生选择时应谨慎考虑。

Abstract: Objective: To retrospectively analyze the effectiveness of proximal femoral nail antirotation and femoral head replacement in the treatment of unstable femoral intertrochanteric fractures. Meth-ods: The clinical data of 123 patients with unstable intertrochanteric fractures admitted to the First People’s Hospital of Yichang from January 2017 to January 2022 were retrospectively analyzed. Ac-cording to the operation method, 80 patients were included in the proximal femoral nail antirota-tion group, and 43 patients were included in the femoral head replacement group. The pain, hip joint function, and complications were compared between the two groups. Results: After more than 3 months of follow-up, the Harris score of hip joint function in the proximal femoral nail antirotation group was higher than that in the femoral head replacement group, and the difference was statisti-cally significant (P < 0.05); the incidence of postoperative complications in the proximal femoral nail antirotation group was lower than that in the femoral head replacement group, and the differ-ence was statistically significant (P < 0.05). Conclusion: In the treatment of unstable intertrochan-teric fractures, proximal femoral nail antirotation has higher Harris hip score, better hip function recovery, better pain relief, and fewer complications. Femoral head replacement in the treatment of unstable femoral intertrochanteric fractures has many complications, which should be carefully considered by clinicians.