系统化康复在急诊微创PFNA-Ⅱ内固定治疗股骨转子间骨折患者术后的应用效果OA
Effects of Systematic Rehabilitation After Emergency Minimally Invasive PFNA-Ⅱ Fixation in Patients with Intertrochanteric Femoral Fractures
目的 探讨系统化康复在急诊微创亚洲型防旋股骨近端髓内钉(PFNA-Ⅱ)内固定治疗股骨转子间骨折患者术后的应用效果.方法 回顾性选取2023年8月至2025年1月在郑州市骨科医院急诊入院的94例股骨转子间骨折患者,全部行微创PFNA-Ⅱ内固定治疗.根据术后功能锻炼方案差异分为观察组和对照组,各47例.对照组予以传统康复宣教,观察组则开展全流程、分阶段的康复管理.比较两组围术期指标、不同随访节点的髋部功能及疼痛评分、骨折愈合时间,并记录两组不良事件发生率及康复优良率.结果 观察组术后下床活动时间、住院时间均短于对照组,术后1个月、3个月、6 个月、12 个月 Harris 评分均高于对照组,术后 1 个月、3 个月、6 个月视觉模拟评分法(VAS)评分均低于对照组,骨折愈合时间短于对照组,并发症发生率低于对照组,差异均有统计学意义(P＜0.05);两组手术时间、术中出血量、康复优良率比较,差异均无统计学意义(P＞0.05).结论 在急诊微创 PFNA-Ⅱ内固定治疗股骨转子间骨折患者中,术后系统化康复与更早下床、更短的住院及骨折愈合时间、较好的髋关节功能和较轻的疼痛相关,但其对康复优良率及并发症的影响仍需进一步研究验证.
Objective To investigate the effects of systematic rehabilitation after emergency minimally invasive proximal femoral nail antirotation-Ⅱ(PFNA-Ⅱ)fixation in patients with intertrochanteric femoral fractures.Methods A total of 94 patients with intertrochanteric femoral fractures who were admitted through the emergency department of Zhengzhou Orthopedic Hospital from August 2023 to January 2025 were retrospectively included.Patients underwent minimally invasive PFNA-Ⅱfixation.According to the postoperative functional exercise regimen,the patients were divided into an observation group and a control group,with 47 patients in each group.The control group received conventional rehabilitation education,whereas the observation group received comprehensive,stage-specific rehabilitation management throughout the recovery process.Perioperative indicators,hip function and pain scores at different follow-up time points,and fracture healing time were compared between the two groups.The incidence of adverse events and the rate of excellent or good rehabilitation outcomes were also recorded.Results The time to postoperative ambulation and length of hospital stay were shorter in the observation group than in the control group.Harris hip scores at 1,3,6,and 12 months after surgery were higher,whereas visual analog scale(VAS)pain scores at 1,3,and 6 months after surgery were lower in the observation group.Fracture healing time was also shorter,and the incidence of complications was lower in the observation group,with statistically significant differences(P＜0.05).No statistically significant differences were observed between the two groups in operative time,intraoperative blood loss,or the rate of excellent or good rehabilitation outcomes(P＞0.05).Conclusion In patients with intertrochanteric femoral fractures treated with emergency minimally invasive PFNA-Ⅱ fixation,postoperative systematic rehabilitation is associated with earlier ambulation,shorter hospital stay and fracture healing time,better hip function,and less pain.However,its effects on the rate of excellent or good rehabilitation outcomes and postoperative complications require further investigation.
周明杨;张威
郑州市骨科医院 急诊科,河南 郑州 450000郑州市骨科医院 微创骨科,河南 郑州 450000
微创PFNA-Ⅱ内固定术急诊干预股骨转子间骨折系统化康复
minimally invasive PFNA-Ⅱ fixationemergency interventionintertrochanteric femoral fracturesystematic rehabilitation
《临床研究》 2026 (9)
79-82,4
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