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目的探讨股骨近端防旋髓内钉(PFNA)内固定治疗老年煤矿工人骨质疏松性股骨粗隆间骨折术后早期疗效的影响因素。方法笔者自2013-09—2014-10采用PFNA内固定治疗老年煤矿工人骨质疏松性股骨粗隆间骨折40例,采用多元线性回归分析的方法,分析影响术后早期疗效的因素。结果所有患者术中均达到良好复位,颈干角恢复正常。术后切口均一期愈合,无感染并发症。骨折均达骨性愈合,术后6个月疗效按髋关节功能Harris评分标准评定为65~97(83.5±8.38)分,优17例,良11例,可9例,差3例。采用多元线性回归分析结果表明,髋关节功能和T值、BMI、负重时间、及是否伴有小粗隆骨折存在线性相关。结论 PFNA治疗老年煤矿工人骨质疏松性股骨粗隆间骨折术后早期的髋关节功能和骨密度、负重时间、是否存在小粗隆骨折、BMI指数有密切相关性。
Objective To investigate the factors influencing the early curative effect of osteoporotic femoral intertrochanteric fractures in elderly coal miners after internal fixation with proximal femoral nailing (PFNA). Methods From 2013-09-2014-10, the author used PFNA internal fixation to treat 40 cases of osteoporotic femoral intertrochanteric fractures in elderly coal miners. The factors influencing the early postoperative curative effect were analyzed by multivariate linear regression analysis. Results All patients achieved a good intraoperative resection, neck angle returned to normal. Postoperative incision healed, no infection complications. The fractures reached the bony union after 6 months. The curative effect was 65-97 (83.5 ± 8.38) points according to the Harris score of hip joint function. The results were excellent in 17 cases, good in 11 cases, fair in 9 cases and poor in 3 cases. The results of multivariate linear regression analysis showed that there was a linear correlation between hip function and T value, BMI, weight-bearing time, and whether there was a small trochanter fracture. Conclusion PFNA treatment of osteoporotic femoral intertrochanteric fractures in elderly coal miners early postoperative hip function and bone mineral density, weight-bearing time, the presence of small trochanter fractures, BMI index are closely related.