InterTan髓内钉治疗股骨转子间骨折的初步疗效观察  

Initial clinical outcomes of intramedullary fixation of intertrochanteric fractures with InterTan nails

作　　者：吕刚[1] 陈平波[1] 吕发明[1] 盂庆才[1] 阿布杜热合曼[1] 艾克巴尔[1] 杨春[1] 郎毅[1] 

机构地区：[1]新疆医科大学附属中医医院骨科,乌鲁木齐830000

出　　处：《中华创伤骨科杂志》2010年第1期48-52,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨新一代股骨近端髓内钉InterTan治疗股骨转子间骨折的临床疗效。方法2008年7月至2009年3月共收治27例股骨转子间骨折患者，男15例，女12例；左侧13例，右侧14例；年龄40～86岁（平均67．5岁）。骨折根据改良Evan标准分型：lA型4例，IB型6例，ⅡA型8例，ⅡB型7例，Ⅲ型2例。11例合并严重骨质疏松。27例患者受伤至手术时间平均为4．4d（1～9d）。所有患者均采用InterTan髓内钉治疗。对患者手术情况、术后Harris髋关节评分、疼痛、骨折愈合、X线片随访及术后并发症等情况进行评估。结果27例患者手术时间平均为（56±12）min（35～126min），失血量平均为（176±42mL）（115～440mL）。26例患者术后获平均8个月（5～11个月）随访，1例术后2个月死亡。26例患者骨折均获愈合，平均愈合时间为（2．9±0．7）个月（2～6个月）。术后Harris髋关节评分评定结果：优9例，良11例，中4例，差2例，优良率为76．9％。术后92．6％的患者在短期内疼痛缓解。3例出现头颈部短缩，无髋内翻、骨干骨折和内置物失效、断裂等并发症发生。结论新一代股骨近端髓内钉InterTan治疗股骨转子间骨折可取得较为满意的临床疗效，骨愈合率高，并发症少。Objective To report the clinical results of a new kind of intertroehanteric antegrade nail, InterTan, used for the treatment of intertroehanterie fractures. Methods From July 2008 to March 2009, 27 consecutive patients with an intertrochanteric fracture were treated with InterTan. The mean age of the patients was 67.5 （40 to 86） years. Their surgical data, Harris hip score, pain, walking, X-radiographs, union and complications were analyzed retrospectively. Results Their average surgical time was （56 ± 12） （35 to 126） minutes. Their mean follow-up time was 8 （5 to 11） months. One patient died 2 months postoperatively. All fractures healed within an average of 2.9 ± 0. 7 （2 to 6） months. By the Harris hip score, 9 patients had exeellent results, 11 good, 4 fair and 2 poor. The good to excellent rate was 76.9%. Pain was relieved soon after surgery in 92.6% of the patients. Follow-up showed that only one patient died. Collapse of the neck was observed in 3 eases, but no eoxa vara, no femoral shaft fracture, or no implant failure was observed. Conclusion The new intertrochanteric antegrade nail, InterTan, can be used to treat various kinds of femoral intertrochanteric fraetures with good elinieal results.

关 键 词：髋骨折 骨折固定术 内 骨钉 

分 类 号：R686[医药卫生—骨科学]