特殊复位器复位重建钉治疗同侧股骨干及髋部骨折的临床研究  

Ipsilateral Fractures of the Hip and Shaft of the Femur treated with Reconstructive Nailing under the Assistance of an Reduction Device

作　　者：王伟[1] 张敏[1] 刘建宁[1] 李志勇 徐国辉[1] WANG Wei;ZHANG Min;LIU Jianning(Xiangjiang Area of The Third Hospital of Hebei Medical University,Hebei Shijiazhuang 050000,Chin)

机构地区：[1]河北医科大学第三医院湘江院区骨四科,河北石家庄050000

出　　处：《河北医学》2018年第5期714-718,共5页Hebei Medicine

基　　金：河北省卫生和计划生育委员会科研基金项目;(编号:20170638)

摘　　要：目的:探讨应用特殊复位器经皮辅助复位微创重建钉(RN)固定治疗同侧股骨干合并髋部骨折(IFHSFs)的手术方法及其临床疗效。方法:自2013年1月至2016年1月,应用特殊复位器-T形钉经皮辅助复位微创RN固定治疗21例IFHSFs患者。记录手术时间、术中复位时间、透视时间、出血量及手术前后视觉模拟评分法(VAS)疼痛评分,观察并记录患者术后患肢骨折愈合时间、功能恢复及髋关节Harris评分情况。结果:21例患者术中均通过应用T形钉辅助复位达到闭合复位。本组患者手术时间74.57±14.17min;术中复位时间12.69±2.61min;术中透视时间19.24±11.08s;术中出血量130.48±23.29m L;术后患者的视觉模拟评分法(VAS)评分明显低于术前(P<0.05);所有病例均获得随访,所有骨折愈合时间5.00±3.33个月,骨折愈合时患侧与健侧髋关节Harris评分无明显差异(P>0.05),依据Friedman-Wyman疗效评价标准均达到优良标准。结论:应用T形钉经皮复位微创RN固定治疗IFHSFs具有闭合复位创伤小、出血量小、功能恢复好、一次手术即可固定多处骨折等优点,值得临床推广。Objective： To evaluate the curative effect and surgical skills of reconstructive intramedullary nailing in the treatment of ipsilateral fractures of the hip and shaft of the femur（ IFHSFs） with the assistance of an reduction device by percutaneous techniques. Methods： From January 2013 to January 2016,21 adult patients with IFHSFs were enrolled into this study. All the patients were treated with reconstructive nailing（ RN） by percutaneous techniques under the assistance of the reduction device. The operation time,reduction time,fluoroscopy time,intra-operative blood loss and preoperative and postoperative pain score of VAS were recorded. Follow-up was conducted to assess the healing of the fractures,the functional recovery and Harris hip score of the affected limbs. Results： All the 21 cases were achieved closed reduction. The average operative time,fracture reduction time,fluoroscopy time and blood loss were 74. 57 ± 14. 17 minutes,12. 69 ± 2. 61 minutes,19.24±11.08 seconds and 130.48±23.29 m L,respectively. All fractures healed well on an average of5.00±3.33 months. The pain score of VAS in preoperation was significantly less than in postoperation（ P〈0.05）. According to Friedman-Wyman classification 21 cases get good result. There were no significant differences between the Harris hip score of the affected and healthy limbs when the fractures were union. Conclusions： IFHSFs treated with RN under the assistance of the reduction-T pin by percutaneous techniques is a good choice for ipsilateral fractures of the hip and shaft of the femur with the advantages of less soft tissue trauma,less complications,less intra-operative blood loss,excellent functional recovery and less cost.

关 键 词：股骨干骨折 髋部骨折 重建钉 特殊复位器 

分 类 号：R687.3[医药卫生—骨科学]