防旋髓内钉与锁定钢板置入修复高龄股骨转子间不稳定骨折:髋关节功能比较  

Nail anti-rotation blade versus locking plate for the repair of elderly unstable intertrochanteric fractures: hip function

作　　者：吴晗[1] 张鉴[1] 李强[1] 袁琦[1] 

机构地区：[1]昆山市第一人民医院友谊院区骨科,江苏省昆山市215300

出　　处：《中国组织工程研究》2015年第22期3550-3554,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:老年患者骨质较为疏松,骨折后骨头粉碎的情况居多,同时很多老年患者并发很多内科疾病,各类脏器功能不足,手术承受能力差,也为内固定治疗带来了困难,增加了治疗风险,所以在内固定方法的选择上不统一。目的:对比分析股骨近端防旋髓内钉螺旋刀片与股骨近端解剖型锁定钢板对高龄股骨转子间不稳定骨折的修复效果。方法:选择昆山市第一人民医院友谊院区2011年4月至2013年6月收治的高龄股骨转子间不稳定骨折患者100例,随机分成2组。实验组患者给予股骨近端防旋髓内钉螺旋刀片置入内固定,对照组患者则给予股骨近端解剖型锁定钢板置入内固定。治疗后采用随访的方式,对两组骨折患者的术中指标、治疗后髋关节功能Harris评分以及并发症发生情况进行对比分析。结果与结论:两组患者术中各项指标差异无显著性意义(P>0.05)。实验组患者的髋关节功能Harris评分明显优于对照组(P<0.05),同时实验组患者的治疗后并发症发生率明显低于对照组(P<0.05)。提示股骨近端防旋髓内钉螺旋刀片置入修复高龄股骨转子间不稳定骨折,具有关节功能恢复好,并发症少的优势。BACKGROUND： Elderly patients have more loose bone. After fractures, bones are mostly crushed. Simultaneously, many elderly patients experience many internal diseases. Various organs have dysfunction. Surgery tolerance is poor, which also brings difficulty in treatment with internal fixator, and increases the risk of therapy. Thus, the choice of internal fixation method is not uniform. OBJECTIVE： To compare and analyze the repair effects of proximal femoral nail anti-rotation blade and anatomic proximal femoral locking plate in treatment of unstable intertrochanteric fractures in the elderly. METHODS： A total of 100 elderly patients with unstable intertrochanteric fractures were selected from the Youyi Branch, Kunshan First People＇s Hospital from April 2011 to June 2013. They were randomly assigned to two groups. Patients in the experimental group received internal fixation with proximal femoral nail anti-rotation blade. Patients in the control group received anatomic proximal femoral locking plate. After treatment, follow-up was conducted. Operative indexes, postoperative Harris score for hip function and incidence of complications were compared and analyzed in both groups. RESULTS AND CONCLUSION： No significant difference in various indexes was detected in both groups（P〉0.05）. Harris scores were significantly better in the experimental group than in the control group（P〈0.05）. Postoperative complications were significantly less in the experimental group than in the control group（P〈0.05）.These results indicated that internal fixation of proximal femoral nail anti-rotation blade for unstable intertrochanteric fractures in the elderly achieved satisfactory results in the recovery of joint function and had the advantage of few complications.

关 键 词：骨折固定术 内固定器 随访研究 植入物 骨植入物 高龄股骨转子间不稳定骨折 股骨近端防旋髓内钉螺旋刀片 股骨近端解剖型锁定钢板 骨折内固定 

分 类 号：R318[医药卫生—生物医学工程]