| 吴 丹,鄢江文.小切口辅助复位在股骨转子间骨折中的应用效果分析[J].中国烧伤创疡杂志,2024,(6):464~467. |
| DOI： |
| 中文关键词: 股骨近端 防旋髓内钉 小切口辅助复位 股骨转子间骨折 髋关节功能 |
| 英文关键词:Proximal femur Nail antirotation Small-incision assisted reduction Femoral intertrochanteric
fracture Hip joint function |
| 基金项目: |
|
| 摘要点击次数: 299 |
| 全文下载次数: 713 |
| 中文摘要: |
| 【摘要】 目的 分析小切口辅助复位在股骨转子间骨折中的应用效果。 方法 选取 2019 年 10 月至 2023 年2 月铜鼓县人民医院收治的 108 例股骨转子间骨折患者作为研究对象, 按照不同治疗方式将其分为小切口组 (54例) 与传统组 (54 例), 小切口组患者行小切口辅助复位联合股骨近端防旋髓内钉 (PFNA) 内固定治疗, 传统组患者行传统复位联合 PFNA 内固定治疗, 对比观察两组患者手术相关指标、前内侧皮质复位情况、髋关节功能与并发症发生情况。结果 小切口组患者术中失血量明显多于传统组 (t = 2.006, P= 0.047)、手术时间明显长于传统组 (t = 3.663, P= 0.001)。 术后即刻, 小切口组患者骨折端前内侧皮质复位情况为中性支撑 9 例、正性支撑45 例, 明显优于传统组患者的负性支撑 5 例、中性支撑 18 例、正性支撑 31 例 (Z= -3.086, P= 0.002)。出院时及术后 6 个月, 小切口组患者 Harris 评分均明显高于传统组 (t = 2.396、3.826, P= 0.018、P<0.001)。小切口组患者并发症发生率为 5.56%, 与传统组患者的并发症发生率 11.11%无明显差异 ( χ2 = 1.091, P = 0.296)。结论 小切口辅助复位联合 PFNA 内固定治疗股骨转子间骨折, 虽术中失血量较大、手术时间较长, 但能明显提高骨折端前内侧皮质复位质量及髋关节功能恢复效果。 |
| 英文摘要: |
| 【Abstract】 Objective To analyze the clinical efficacy of small-incision assisted reduction in femoral intertrochan-teric fracture. Methods 108 patients with femoral intertrochanteric fracture admitted to Tonggu People’s Hospital from October 2019 to February 2023 were enrolled as the research subjects, and divided into the small?incision group (n = 54), receiving small?incision assisted reduction combined with proximal femoral nail antirotation (PFNA) internal fixation, and the traditional group (n = 54), receiving the traditional reduction combined with PFNA internal fixation. The surgery-related indexes, anteromedial cortex reduction, hip joint function and the occurrence of complications were compared between the two groups. Results The intraoperative blood loss volume of patients in the small-incision group was significantly more than that in the traditional group ( t = 2.006, P = 0.047), and the operation time was significantly longer in the small-incision group (t = 3.663, P= 0.001). Immediately after surgery, the reduction of the anteromedial cortex at the fracture end was anatomic reduction in 9 cases and positive buttress position in 45 cases in the small-incision group, which was significantly better than that of the patients in the traditional group (Z = -3.086, P = 0.002) -negative buttress position in 5 cases, anatomic reduction in 18 cases, and positive buttress position in 31 cases. Respectively at discharge and on month 6 after operation, the Harris scores of patients was significantly higher in the small-incision group compared with the traditional group (t = 2.396 and 3.826, P = 0.018, P < 0.001). The incidence of postoperative complications was 5.56% in the small-incision group, showing no significant difference compared with the 11.11% in the traditional group (χ2 = 1.091, P=0.296). Conclusion Small-incision assisted reduction combined with PFNA internal fixation in treating femoral intertro-chanteric fracture can significantly improve the quality of anteromedial cortical reduction at the fracture end and the recovery effect of hip joint function, though it may result in greater intraoperative blood loss volume and longer operation time. |
|
|
|
|
