InterTAN和解剖型锁定加压钢板治疗股骨转子下长段粉碎性骨折的比较研究  

Therapeutic Effect of Anti-rotation Proximal Femoral Intramedullary Nail and Anatomic Locking Compression Plate in Comminuted Fracture of Long Segment of Femur

作　　者：武京伟[1] 刘利民[1] 高志华[1] 胡怀建[1] Wu Jingwei;Liu Limin;Gao Zhihua(Department of Orthopedics,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院骨科

出　　处：《实用骨科杂志》2019年第8期695-699,共5页Journal of Practical Orthopaedics

摘　　要：目的探讨联合加压交锁髓内钉(TriGen InterTAN hip fracture nailing system,InterTAN)和解剖型锁定加压钢板(locking compression plate,LCP)在股骨转子下长段粉碎性骨折患者中的治疗效果及安全性分析。方法回顾性分析2016年3月至2017年2月,我院收治的59例股骨转子下长段粉碎性骨折患者的临床资料,根据患者手术内固定方式不同分为I组(InterTAN内固定治疗,27例)和L组(LCP内固定治疗,32例),比较两组患者围手术期指标、术后愈合情况、髋膝关节功能恢复情况及并发症发生情况。结果 I组患者的手术时间、术中出血量、切口长度、引流液量均低于L组,术中透视次数多于L组(P<0.05)。两组患者下床活动时间比较,差异无统计学意义(P>0.05);I组患者骨折愈合时间短于L组(P<0.05)。I组患者髋关节优良率高于L组,分别为96.00%和68.97%(P<0.05)。I组和L组膝关节功能优良率分别为96.00%和89.66%,两组比较差异无统计学意义(P>0.05)。I组和L组在内固定松动、深静脉血栓形成、膝关节僵硬、骨折愈合延迟、畸形愈合、股骨头坏死、切口感染发生率方面比较,差异无统计学意义(P>0.05)。结论 InterTAN在股骨转子下长段粉碎性骨折治疗中,相对LCP可减少手术创伤,促进患者术后康复和愈合,提高髋关节功能。Objective To investigate the efficacy and safety of anti-rotation proximal femoral nail(InterTAN) and anatomic locking compression plate(LCP) in the treatment of comminuted fractures in the long segment of the femur.Methods We selected and retrospectively analysed of clinical data of 59 patients with comminuted femoral fractures in our department from March 2016 to February 2017 in our hospital,according to different methods of internal fixation,patients were divided into group I(InterTAN internal fixation,27 cases) and group L(LCP internal fixation,32 cases).Peroperative indications,postoperative recovery,hip and knee joints functional recovery and complications were compared between the two groups.Results The operation time,intraoperative blood loss,incision length,and drainage volume in group I were all lower than those in group L.Times of intraoperative fluoroscopy was more than that in group L(P<0.05).There was no statistically significant difference in the time of getting out of bed between the two groups(P>0.05).The fracture healing time in group I was shorter than that in group L(P<0.05).The hips in the I group had a better rate than the L group [96.00% vs.68.97%,P<0.05].There was no statistically significant difference in the rate of excellent knee function in the I and L groups [96.00% vs.89.66%,P>0.05].There was no statistically significant difference in the rates of loose fixation,deep venous thrombosis,stiffness of the knee joint,delayed fracture healing,malunion,femoral head necrosis,and incision infection in the I and L groups(P>0.05).Conclusion In the long segment fracture of the lower femur,InterTAN can reduce surgical trauma,promote postoperative recovery and healing,and improve hip function compared with LCP.

关 键 词：股骨转子 粉碎性骨折 防旋型股骨近端髓内钉 解剖型锁定加压钢板 

分 类 号：R683.42[医药卫生—骨科学]