股骨转子间骨折的髓内钉治疗:新设计的具有远端导针定位器的导向开口器的应用  

Treatment with locking intramedullary nailing for intertrochanteric fracture of femur: application of a new opening guider with distal positioner

作　　者：李琪[1] 罗政强 徐飞 郑泽航 付涛 王体沛[2] Li Qi;Luo Zhengqiang;Xu Fei(Department of Emergency Surgery,Fujian Provincial Hospital,Provincial Clinical Medical College,Fujian Medical University,Fuzhou Fujian,350001;Department of Orthopedics,Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science&Technology,Wuhan Hubei,430030,China)

机构地区：[1]福建医科大学省立临床医学院,福建省立医院急诊外科,福建福州350001 [2]华中科技大学同济医学院附属同济医院骨科,湖北武汉430030

出　　处：《生物骨科材料与临床研究》2018年第6期70-73,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨新设计的具有远端导针定位器的导向开口器在髓内钉治疗股骨转子间骨折的疗效,并对导向开口器及远端定位器的准确性及安全性进行验证。方法回顾性分析36例股骨转子间骨折的患者,根据当时术中使用开口器的类型分为对照组与实验组,其中实验组的18例患者采用新的具有远端导针定位器的导向开口器进行髓内钉治疗,对照组的18例患者采用常规开口器进行操作。详细介绍具有远端定位器的导向开口器的应用。统计并比较两组患者的手术操作时间、手术出血量、一次性穿针成功率和术中透视次数。结果实验组患者手术时间(52.9±9.3)min小于对照组(68.4±15.1)min(<0.05);实验组一次性穿针成功率为100%,明显高于对照组66.7%;术中透视次数,实验组为(17.1±4.3)次,明显少于对照组(31.3±8.3)次(<0.05),术中出血量无明显差异,无统计学意义(>0.05)。结论新设计的具有远端导针定位器的导向开口器能够有效且快速进行股骨髓内钉的开口操作,精确插入导针及安全地进行扩髓操作,减少手术时间和透视次数。Objective To estimate the efficacy of a newly designed opening guider with distal positioner in the treatment of intertrochanteric fractures of the femur with intramedullary nails,and verify the accurate and security of the guider.Methods We make a retrospective analysis of36patients with intertrochanteric fracture of femur.The patients were di-vided into a control group and an experimental group according to the type of opener used in the operation.18patients in the experimental group were treated with the new guider for intramedullary nailing.The remaining18patients in the con-sol group were operated with conventional guider.Results TTie operation time of the experimental group was(52.9±9.3)min,which was less than the control group of(68.4±15.1)min(P<0.05).The success rate of one-time needle insertion in the experimental group was100%,which was significantly higher than the66.7%of the control group.The number of intraoperative fluoroscopy in the experimental group was(17.1±4.3)times,which was also obviously lower than the(31.3±8.3)times in the control group(P<0.05).There was no significant difference in intraoperative blood loss(P>0.05).Conclusion The newly designed opening guider with distal positioner not only enables efficient and rapid opening oper-ation of the intramedullary nail,but also allows precise insertion of the guide wire and safe reaming operation.In addition,it has the advantage of decreasing time and the number of intraoperative fluoroscopy.

关 键 词：股骨转子间骨折 交锁髓内钉 开口器 

分 类 号：R683.42[医药卫生—骨科学]