股骨近端防旋髓内钉治疗AO31-A3.1型骨折是否需要钢丝辅助固定对比观察  

Comparative observation of the need for steel wire assisted fixation in the treatment of 31-A3. 1 type AO fracture by proximal femoral nail anti-rotation

作　　者：苏建敏[1] 侯江伟[1] 关春辉[1] 李中心[1] 魏金亮[1] 王勇[1] 

机构地区：[1]郑州市第一人民医院创伤骨科,450000

出　　处：《中国实用医刊》2016年第14期48-51,共4页Chinese Journal of Practical Medicine

摘　　要：目的：观察股骨近端防旋髓内钉（ PFNA）治疗 AO 31-A3.1型骨折是否需要钢丝辅助固定。方法采用随机分组方式，将 AO 31-A3.1型骨折治疗分为闭合复位单纯 PFNA 固定组及切开复位 PFNA 结合钢丝捆扎固定组。观察两组手术时间、术中出血量、骨折愈合时间及 Harris 髋关节评分，评价两组治疗方式的临床效果。结果 PFNA结合钢丝捆扎组患者术中出血量及手术时间较单纯 PFNA 组增加，差异有统计学意义（ P ﹤0.05）；但 PFNA 结合钢丝捆扎组患者骨折愈合时间较单纯 PFNA 组减少，差异有统计学意义（P ﹤0.05）。两组患者术后 Harris 髋关节评分比较差异未见统计学意义（P ﹥0.05）。结论患者身体条件允许的情况下应采用小切口钢丝捆扎结合 PFNA 治疗 AO 31-A3.1型骨折，其有利于骨折端稳定级骨折的早期愈合，减少再手术率及并发症。Objective To observe whether the steel wire assisted fixation is required in the treat-ment of 31-A3. 1 AO type retrograde intertrochanteric fracture by proximal femoral nail anti-rotation（PF-NA）. Methods Patients with AO 31-A3. 1 type retrograde intertrochanteric fracture were randomly di-vided into closed reduction with PFNA group and open reduction of PFNA combined with the steel wire assisted fixation group;observed and compared the operation time,blood loss,fracture healing time and Harris hip Rating,and then the clinical effects of the two groups were compared. Results Blood loss and operation time of PFNA combined with steel wire binding group were more than those of the pure PF-NA group,the differences were statistically significant（P ﹤ 0. 05）,the fracture healing time of PFNA combined with wire binding group was much longer than that of the PFNA group,the difference was sig-nificant（P ﹤ 0. 05）. Harris hip score had no significant difference between the two groups（P ﹥ 0. 05）. Conclusions Under the patient’s physical condition is able to withstand the operation,the treatment of AO 31-A3. 1 type intertrochanteric fracture by PFNA with the steel wire assisted fixation is beneficial to the stability of the fracture,the early healing of the fracture,the decrease of the reoperation rate and the adverse complications.

关 键 词：股骨逆粗隆间/反转子间骨折 31-A3.1型 股骨近端防旋髓内钉 钢丝 

分 类 号：R683.05[医药卫生—骨科学]