改良前外侧肌间隙入路联合动力髋螺钉治疗股骨粗隆间骨折的疗效  

Analysis of curative efficacy of improved anterolateral approach through intermuscular space combined with dynamic hip screw in treatment of intertrochanteric fracture of femur

作　　者：吴炳华[1] 邹帆[2] 张斌[2] 李斌华[2] 骆松[2] 邱平[2] 戴闽[2] 

机构地区：[1]南昌大学第四附属医院骨科,南昌330006 [2]南昌大学第一附属医院骨科,南昌330006

出　　处：《广东医学》2013年第8期1186-1189,共4页Guangdong Medical Journal

基　　金：江西省卫生厅科技计划项目(编号:20074005)

摘　　要：目的探讨改良肌间隙入路联合动力髋螺钉治疗股骨粗隆间骨折的疗效。方法采用经前外侧肌间隙入路联合动力髋螺钉对收治的37例股骨粗隆间骨折患者进行手术治疗。结果所有患者均获得12～24(15.8±3.2)个月的随访。所有患者均于3～6个月后骨性愈合,住院期间无死亡。术后3、6、12个月髋关节Harris功能评分均较术前明显提高,差异均有统计学意义(P<0.05),且随术后时间延长,Harris功能评分逐步提高,差异均有统计学意义(P<0.05)。根据疗效评分标准,优22例,良13例,可2例,差0例,优良率94.6%。术后肺部感染1例,主钉切出股骨头1例,髋内翻畸形2例,并发症发生率为10.8%。结论改良肌间隙入路联合动力髋治疗股骨粗隆间骨折,对肌肉损伤小,减少了肌纤维大量破坏所造成的瘢痕形成,有利于手术暴露及术后早期功能康复锻炼。Objective To evaluate the curative efficacy of improved anterolateral approach through intermuscular space combined with dynamic hip screw in treatment of intertrochanterie fracture of femur. Methods Thirty - seven pa- tients with intertrochanteric fracture of femur were surgically treated with dynamic hip screw through anterolateral approach via intermuscular space. Results A mean follow - up of 15.8 months was carried out （ 12 -24 months）, with successful bone union observed in all patients in 3 to 6 months. No death was reported during the hospitalization. There was signifi- cant time - dependent improvement in Harris score after operation （ P 〈 0. 05 ）. According to curative criteria, excellent, good, general and poor curative effects were reported in 22, 13, 2 and 0, respectively, with complication incidence of 10. 8%. Conclusion The dynamic hip screw combined with anterolateral approach via intermuscular space for treatment of intertrochanteric fracture of femur is helpful to minimize muscle injury and development of scar tissue, providing benefits to surgical exposure and early postoperative rehabilitation.

关 键 词：肌间隙入路 股骨粗隆间骨折 动力髋螺钉 康复 

分 类 号：R683.42[医药卫生—骨科学]