摘要
目的 探讨经骨皮质临时固定技术在股骨转子间骨折行闭合复位股骨近端防旋髓内钉(PFNA)术治疗中维持复位的临床效果。方法 80例行闭合复位PFNA术治疗的股骨转子间骨折患者为研究对象,根据随机数字表法分为对照组和观察组,每组40例。对照组采取常规PFNA手术治疗,观察组采取PFNA术中采取经骨皮质临时固定技术治疗。比较两组临床指标、骨折复位效果、术后并发症发生情况、骨折愈合时间及髋关节评分。结果 两组患者均完成手术,其中观察组术中克氏针植入次数:14例患者植入<4次, 17例患者植入4~7次, 9例患者植入>7次。两组患者手术时间、术中出血量、输血量及术后负重时间比较,差异无统计学意义(P>0.05)。观察组术中透视次数(44.26±3.88)次少于对照组的(56.37±9.46)次,差异有统计学意义(P<0.05)。观察组骨折复位优良率97.5%高于对照组的82.5%,差异有统计学意义(P<0.05)。两组骨折愈合时间比较,差异无统计学意义(P>0.05)。观察组术后1年Harris评分(88.34±2.67)分明显高于对照组的(83.05±2.97)分,差异有统计学意义(P<0.05)。两组患者在随访期间均无切口感染、下肢深静脉血栓形成及二次骨折等相关并发症发生。结论 股骨转子间骨折患者行闭合复位PFNA术中使用经骨皮质临时固定技术可明显维持股骨转子间骨折术中复位效果,提高复位质量,且不增加手术时间和术中出血量,有利于患者术后髋关节功能恢复。
Objective To discuss the clinical effect of transcortical temporary fixation technique in intertrochanteric fractures of the femur treated by closed reduction PFNA.Methods A total of 80 patients with intertrochanteric fractures of the femur treated by closed reduction and proximal femoral nail antirotation(PFNA)were selected as the research subjects,and were divided into the control group and the observation group according to the random numerical table,with 40 cases in each group.The control group was treated with conventional PFNA surgery,while the observation group was treated with transcortical temporary fixation technique during PFNA.The clinical indicators,fracture reduction quality,occurrence of postoperative complications,fracture healing time and hip score were compared between the two groups.Results Patients in both groups completed the surgery,in which the number of intraoperative kirschner wire implantations in the observation group:14 patients had<4 implantations,17 patients had 4-7 implantations,and 9 patients had>7 implantations.There was no statistically significant difference in operation time,intraoperative blood loss,blood transfusion volume and postoperative weight-bearing time between the two groups(P>0.05).The frequency of intraoperative fluoroscopy(44.26±3.88)times in the observation group was less than(56.37±9.46)times in the control group,and the difference was statistically significant(P<0.05).The excellent-good rate of fracture reduction 97.5%in the observation group was higher than 82.5%in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in fracture healing time between the two groups(P>0.05).The Harris score at 1 year after surgery(88.34±2.67)points of the observation group was significantly higher than(83.05±2.97)points of the control group,and the difference was statistically significant(P<0.05).No incision infection,lower extremity deep vein thrombosis,secondary fracture and other related complications occurred in the two groups during the follow-up period.Conclusion For patients with intertrochanteric fractures of the femur,transcortical temporary fixation technique during closed reduction and PFNA can obviously maintain the intraoperative reduction effect,improve the effect of reduction,and does not increase the operation time and intraoperative blood loss,which is beneficial to the postoperative recovery of hip joint function.
作者
刘丹
王鹏
聂瑞祥
LIU Dan;WANG Peng;NIE Rui-xiang(Department of Orthopedics,Xinmin People's Hospital,Xinmin 110300,China)
出处
《中国实用医药》
2022年第23期66-68,共3页
China Practical Medicine
关键词
经骨皮质临时固定技术
股骨转子间骨折
维持复位
股骨近端防旋髓内钉
Transcortical temporary fixation technique
Intertrochanteric fractures of the femur
Maintaining reduction
Proximal femoral nail antirotation
