改良S-P入路不切断股直肌治疗PipkinⅠ和Ⅱ型骨折的疗效  

Therapeutic effect of modified S-P approach without disconnecting the rectus femoris in patients with Pipkin typeⅠandⅡfractures

作　　者：马绍鹏 胡龙[2] Ma Shaopeng Hu Long(Department of Orthopaedics, Guanghe County People＇s Hospital of Gansu Province, Gansu Guanghe 731300, China)

机构地区：[1]甘肃省广河县人民医院骨科,731300 [2]兰州大学第一医院骨科

出　　处：《中国医师进修杂志》2017年第9期803-806,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 评价改良S-P入路不切断股直肌治疗PipkinⅠ和Ⅱ型骨折的疗效.方法回顾性分析58例PipkinⅠ和Ⅱ型骨折患者的临床资料,其中行常规S-P入路并以可吸收螺钉进行固定患者29例（常规组）,行改良S-P入路不切断股直肌再以可吸收螺钉进行固定29例（改良组）.比较两组切口长度、手术时间、术中出血量、术后疼痛视觉模拟评分（VAS）、术后并发症及末次随访时髋关节功能.结果两组患者均未发生手术切口感染,均一期愈合,术后3个月X线片示骨折愈合.常规组和改良组随访时间比较差异无统计学意义[（16.1±5.2）个月比（15.8±5.6）个月,P〉0.05].改良组切口长度、术中出血量、术后3 d和4周VAS明显低于常规组[（8.1±0.8）cm比（12.3±1.2）cm、（144.3±16.5）ml比（172.4±21.6）ml、（4.5±1.1）分比（5.9±1.5）分和（1.6±0.7）分比（2.4±0.8）分],差异有统计学意义（P〈0.05）;两组手术时间、术后3个月VAS、术后并发症发生率和随访末次髋关节功能优良率比较差异无统计学意义（P〉0.05）.结论改良S-P入路不切断股直肌是治疗PipkinⅠ和Ⅱ型骨折的较好方法,具有显露清晰、创伤小、出血量少、术后患者疼痛轻等优势.Objective To investigate the therapeutic effect of modified S-P approach without disconnecting the rectus femoris in patients with Pipkin typeⅠandⅡfractures. Methods The clinical data of 58 patients with Pipkin type Ⅰ and Ⅱfractures were retrospectively analyzed. Among the patients, 29 patients were treated with conventional S-P approach （conventional group）, and 29 patients were treated with modified S-P approach （modified group）. The incision length, operation time, bleeding, visual analogue score （VAS）, postoperative complications and hip joint function at the final follow-up were compared between 2 groups. Results The patients of 2 groups had not incision infection, and showed primary. X-ray of 3 months after surgery showed fracture healing. There was no statistical difference in the time of follow-up between conventional group and modified group：（16.1 ± 5.2） months vs. （15.8 ± 5.6） months, P〉0.05. The incision length, bleeding, VAS 3 d and 4 weeks after surgery in modified group were significantly lower than that in conventional group：（8.1 ± 0.8） cm vs. （12.3 ± 1.2） cm, （144.3 ± 16.5） ml vs. （172.4 ± 21.6） ml, （4.5 ± 1.1） scores vs. （5.9 ± 1.5） scores and （1.6 ± 0.7） scores vs. （2.4 ± 0.8） scores, and there were statistical differences （P〈0.05）. There were no statistical differences in operation time, VAS 3 months after surgery, incidence of postoperative complications and excellent and good rate of hip joint function at the final follow-up between 2 groups （P〉0.05）. Conclusions The modified S-P approach without disconnecting the rectus femoris is a better method in patients with Pipkin type ⅠandⅡ fractures, and it has the advantages of revealing more clearly, minimal invasion, lower bleeding and slight postoperative pain.

关 键 词：髋脱位 股骨头 骨折 回顾性研究 

分 类 号：R687.3[医药卫生—骨科学]